Trial Outcomes & Findings for Islatravir and Methadone Pharmacokinetics (MK-8591-029) (NCT NCT04568603)

NCT ID: NCT04568603

Last Updated: 2025-01-28

Results Overview

The AUC0-24 of R-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

14 participants

Primary outcome timeframe

Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Results posted on

2025-01-28

Participant Flow

Methadone-maintained participants were recruited at 2 study sites in the United States.

Participant milestones

Participant milestones
Measure
Methadone + ISL
Methadone-maintained participants (20 to 200 mg \[locally-provided\] once daily \[QD\] from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with islatravir (ISL) 60 mg.
Overall Study
STARTED
14
Overall Study
Received ISL on Day 2
13
Overall Study
COMPLETED
13
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Methadone + ISL
Methadone-maintained participants (20 to 200 mg \[locally-provided\] once daily \[QD\] from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with islatravir (ISL) 60 mg.
Overall Study
Physician Decision
1

Baseline Characteristics

Islatravir and Methadone Pharmacokinetics (MK-8591-029)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Methadone + ISL
n=14 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Age, Continuous
43.5 Years
STANDARD_DEVIATION 12.0 • n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
Sex: Female, Male
Male
9 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
11 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
12 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The AUC0-24 of R-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized Area Under the Plasma Concentration Time Curve From 0-24 Hours Postdose (AUC0-24) of R-Methadone
Day 1: Methadone Alone
61.9 ng*h/mL/mg
Interval 49.3 to 77.7
Dose-Normalized Area Under the Plasma Concentration Time Curve From 0-24 Hours Postdose (AUC0-24) of R-Methadone
Day 2: Methadone + ISL
63.9 ng*h/mL/mg
Interval 52.2 to 78.1

PRIMARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The AUC0-24hr of S-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized AUC0-24 of S-Methadone
Day 1: Methadone Alone
63.1 ng*h/mL/mg
Interval 48.9 to 81.5
Dose-Normalized AUC0-24 of S-Methadone
Day 2: Methadone + ISL
65.1 ng*h/mL/mg
Interval 51.7 to 82.0

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Cmax of R-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized Maximum Plasma Concentration (Cmax) of R-Methadone
Day 1: Methadone Alone
3.64 ng/mL/mg
Interval 3.0 to 4.43
Dose-Normalized Maximum Plasma Concentration (Cmax) of R-Methadone
Day 2: Methadone + ISL
3.71 ng/mL/mg
Interval 3.14 to 4.4

SECONDARY outcome

Timeframe: Days 1 and 2: 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The C24 of R-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized Plasma Concentration 24 Hours Postdose (C24) of R-Methadone
Day 1: Methadone Alone
2.09 ng/ml/mg
Interval 1.63 to 2.69
Dose-Normalized Plasma Concentration 24 Hours Postdose (C24) of R-Methadone
Day 2: Methadone + ISL
2.23 ng/ml/mg
Interval 1.78 to 2.78

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Tmax of R-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL).

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Time to Maximum Plasma Concentration (Tmax) of R-Methadone
Day 1: Methadone Alone
2.00 hours
Interval 1.47 to 3.0
Time to Maximum Plasma Concentration (Tmax) of R-Methadone
Day 2: Methadone + ISL
2.00 hours
Interval 0.67 to 4.0

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Cmax of S-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized Cmax of S-Methadone
Day 1: Methadone Alone
4.25 ng/mL/mg
Interval 3.45 to 5.25
Dose-Normalized Cmax of S-Methadone
Day 2: Methadone + ISL
4.31 ng/mL/mg
Interval 3.49 to 5.32

SECONDARY outcome

Timeframe: Days 1 and 2: 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The C24 of S-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized C24 of S-Methadone
Day 1: Methadone Alone
1.91 ng/ml/mg
Interval 1.44 to 2.54
Dose-Normalized C24 of S-Methadone
Day 2: Methadone + ISL
2.07 ng/ml/mg
Interval 1.6 to 2.68

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Tmax of S-methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL).

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Tmax of S-Methadone
Day 1: Methadone Alone
1.50 hours
Interval 1.02 to 3.0
Tmax of S-Methadone
Day 2:Methadone + ISL
2.00 hours
Interval 0.67 to 3.0

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The AUC0-24hr of total methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized AUC0-24 of Total Methadone
Day 1: Methadone Alone
126 ng*h/mL/mg
Interval 99.1 to 159.0
Dose-Normalized AUC0-24 of Total Methadone
Day 2: Methadone + ISL
129 ng*h/mL/mg
Interval 105.0 to 160.0

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Cmax of total methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized Cmax of Total Methadone
Day 1: Methadone Alone
7.91 ng/mL/mg
Interval 6.48 to 9.66
Dose-Normalized Cmax of Total Methadone
Day 2: Methadone + ISL
8.02 ng/mL/mg
Interval 6.64 to 9.68

SECONDARY outcome

Timeframe: Days 1 and 2: 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The C24 of total methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL). Back-transformed least-squares mean and confidence interval from mixed effects model were performed on natural log-transformed values; data show the geometric least squares mean.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Dose-Normalized C24 of Total Methadone
Day 1: Methadone Alone
4.03 ng/ml/mg
Interval 3.1 to 5.23
Dose-Normalized C24 of Total Methadone
Day 2: Methadone + ISL
4.32 ng/ml/mg
Interval 3.42 to 5.45

SECONDARY outcome

Timeframe: Days 1 and 2: predose and 0.5, 1, 1.5, 2, 3, 4, 6, 12, 16, and 24 hours postdose

Population: All participants who complied with the protocol sufficiently to ensure that generated data were likely to exhibit the effects of treatment, according to the underlying scientific model, are included.

The Tmax of total methadone was determined on Day 1 (methadone) and Day 2 (methadone + ISL).

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Tmax of Total Methadone
Day 1: Methadone Alone
2.00 hours
Interval 1.47 to 3.0
Tmax of Total Methadone
Day 2: Methadone + ISL
2.00 hours
Interval 0.67 to 3.0

SECONDARY outcome

Timeframe: Up to 16 days

Population: All participants who received ISL on Day 2 are included.

The number of participants with AEs will be determined for 14 days after coadministration of methadone and ISL on Day 2.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Number of Participants With Adverse Events (AEs) Following Methadone + ISL Coadministration
4 Participants

SECONDARY outcome

Timeframe: Up to 15 days

Population: All participants who received ISL on Day 2 are included.

The number of participants discontinuing study therapy due to AEs after methadone + ISL on Day 2 will be determined.

Outcome measures

Outcome measures
Measure
Methadone + ISL
n=13 Participants
Methadone-maintained participants (20 to 200 mg \[locally-provided\] QD from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Number of Participants Discontinuing Study Therapy Due to AEs Following Coadministration of Methadone and ISL
0 Participants

Adverse Events

Methadone + ISL

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Methadone + ISL
n=14 participants at risk
Methadone-maintained participants (20 to 200 mg \[locally-provided\] once daily \[QD\] from Day -14 to Day -1) receive their usual methadone dose on Day 1 and Days 3 to 14. On Day 2, methadone is coadministered with ISL 60 mg.
Gastrointestinal disorders
Vomiting
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
General disorders
Infusion site extravasation
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Metabolism and nutrition disorders
Increased appetite
14.3%
2/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Nervous system disorders
Headache
14.3%
2/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Psychiatric disorders
Anxiety
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Psychiatric disorders
Nightmare
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Skin and subcutaneous tissue disorders
Papule
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.
Skin and subcutaneous tissue disorders
Pruritus
7.1%
1/14 • Up to 16 days (up to 14 days after methadone + ISL coadministration on Day 2)
All enrolled study participants are included in analysis of all-cause mortality. All participants who received ISL on Day 2 are included in analysis of serious AEs (SAEs) and nonserious AEs.

Additional Information

Senior Vice President, Global Clinical Development

Merck Sharp & Dohme Corp.

Phone: 1-800-672-6372

Results disclosure agreements

  • Principal investigator is a sponsor employee If publication activity is not directed by the Sponsor, the investigator agrees to submit all manuscripts or abstracts to the Sponsor before submission.
  • Publication restrictions are in place

Restriction type: OTHER