A pilot phase 2a, randomized, double-blind, placebo-controlled study to explore the antiviral activity, clinical outcomes, safety, and tolerability of rilematovir at two dose levels in non-hospitalized adults with respiratory syncytial virus infection.

Autor: Nilsson AC; Infectious Disease Research Unit, SUS Malmö, Lund University, Lund, Sweden., Pullman J; Mercury Street Medical, Butte, MT, USA., Napora P; Centrum Badań Klinicznych, Wrocław, Poland., Luz K; Federal University of Rio Grande do Norte, Campus Universitário - Lagoa Nova, Natal, RN, Brazil., Gupta A; Albion Finch Medical Centre, Etobicoke, ON, Canada., Draghi J; Centro de Investigacion Clinica Aplicada, Hospital Regional Español, Bahía Blanca, Provincia de Buenos Aires, Argentina., Guzman Romero AK; RM Pharma Specialists, Col del Valle Centro, Benito Juárez, Ciudad de México, CDMX, Mexico., Aggarwal N; Aggarwal and Associates Limited, Brampton, ON, Canada., Petrova G; Trakia University, Stara Zagora, Bulgaria., Ianus J; Janssen Pharmaceuticals, Titusville, NJ, USA., Vijgen L; Janssen Research & Development, Beerse, Belgium., Scott J; Janssen Global Services, High Wycombe, Buckinghamshire, UK., Sinha R; Janssen Pharmaceuticals, Titusville, NJ, USA. Electronic address: rsinha1@ITS.JNJ.com., Rusch S; Janssen Research & Development, Beerse, Belgium., Huntjens D; Janssen Research & Development, Beerse, Belgium., Bertzos K; Janssen Global Services, Horsham, PA, USA., Stevens M; Janssen Research & Development, Beerse, Belgium.
Jazyk: angličtina
Zdroj: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2023 Oct; Vol. 29 (10), pp. 1320-1327. Date of Electronic Publication: 2023 Jul 06.
DOI: 10.1016/j.cmi.2023.07.004
Abstrakt: Objectives: To assess the antiviral effect, clinical outcomes, and safety of the respiratory syncytial virus (RSV) fusion inhibitor rilematovir in non-hospitalized RSV-infected adults.
Methods: This phase 2a, double-blind, multicentre study randomly assigned RSV-positive adult outpatients ≤5 days from symptom onset 1:1:1 to receive rilematovir 500 mg, 80 mg, or placebo once-daily for 7 days. Antiviral effect was assessed by RSV RNA viral load (VL), measured by quantitative RT-PCR, and Kaplan-Meier (KM) estimates of time to undetectable VL. Clinical course was assessed by KM estimates of median time to resolution of key RSV symptoms assessed through patient-reported outcomes.
Results: RSV-positive patients (n = 72) were randomly assigned; 66 had confirmed RSV infection and received rilematovir 500 mg (n = 23), 80 mg (n = 21) or placebo (n = 22). Differences versus placebo in mean RSV RNA VL area under the curve (90% CI) through days 3, 5 and 8, respectively, were 0.09 (-0.837; 1.011), -0.10 (-2.171; 1.963), and -1.03 (-4.746; 2.682) log 10 copies.day/mL for rilematovir 500 mg, and 1.25 (0.291; 2.204), 2.53 (0.430; 4.634), and 3.85 (0.097; 7.599) log 10 copies.day/mL for rilematovir 80 mg. KM estimates of median (90% CI) time-to-first confirmed undetectable VL were 5.9 (3.85; 6.90), 8.0 (6.86; 12.80) and 7.0 (6.62; 10.88) days and 5.7 (2.93; 7.01), 8.1 (6.74; 12.80) and 7.9 (6.62; 11.74) days in patients with symptom onset ≤3 days, for rilematovir 500 mg, 80 mg, and placebo, respectively. KM estimates of median (90% CI) time to resolution of key RSV symptoms were 7.1 (5.03; 11.43), 7.6 (5.93; 8.32), and 9.6 (5.95; 14.00) days for rilematovir 500 mg, 80 mg, and placebo, respectively; and in patients with symptom onset ≤3 days, median 8.0, 7.6, and 11.8 days, respectively.
Discussion: Rilematovir use, initiated early, suggests a potential clinical benefit in RSV-infected adults, with data supporting development of RSV therapeutic options.
Trial Registration: This study is registered with clinicaltrials.gov (NCT03379675).
(Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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