The US Food and Drug Administration (FDA) approved a label update to include a 200 mg formulation of Intelence (etravirine), a Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) indicated for the treatment of Human Immunodeficiency Virus (HIV-1) in treatment-experienced adults with resistance to an NNRTI and other antiretroviral (ARV) agents.
The recommended oral dose of Intelence tablets is 200 mg (one 200 mg tablet or two 100 mg tablets) taken twice daily following a meal. The new 200 mg product formulation is expected to launch in the US later this month, and the 100 mg tablet will remain available. Patients who are unable to swallow Intelence tablets whole may disperse the tablets in a glass of water.
The FDA granted accelerated approval to Intelence in January 2008, and it has since been approved in more than 65 countries. Intelence received traditional FDA approval in November 2009, based on 48-week data from the DUET-1 and DUET-2 studies, and is currently marketed in the US by Tibotec Therapeutics, a division of Centocor Ortho Biotech Products, L.P.
Intelence, in combination with other antiretroviral agents, is indicated for the treatment of HIV-1 infection in ARV treatment-experienced adult patients who have evidence of viral replication and HIV-1 strains resistant to an NNRTI and other ARV agents. This indication is based on Week 48 analyses from two randomized, double-blind, placebo-controlled trials of Intelence. Both studies were conducted in clinically advanced, three-class ARV (NNRTI, N[t] RTI, PI) treatment-experienced adults.
The following points should be considered when initiating therapy with Intelence: treatment history and, when available, resistance testing should guide the use of Intelence, the use of other active ARV agents with Intelence is associated with an increased likelihood of treatment response. In patients who have experienced virologic failure on an NNRTI-containing regimen, do not use Intelence in combination with only N[t] RTIs. The risks and benefits of INTELENCE have not been established in paediatric patients or in treatment-naïve adult patients.
The DUET studies, identical in design and conducted across the Americas, Australia, Canada, Europe and Thailand, examined the use of INTELENCE in combination with other ARV agents in adult treatment-experienced HIV-1 patients with documented resistance to NNRTIs and protease inhibitors (PIs). Participants in the DUET studies were randomized to receive Intelence 200 mg twice daily or placebo, each given in addition to a Background Regimen (BR). For all patients, the BR included darunavir/ritonavir, plus at least two investigator-selected antiretroviral drugs (N (t) RTIs with or without enfuvirtide).
Intelence does not cure HIV infection or AIDS, and does not prevent passing HIV to others. Severe skin and hypersensitivity reactions: severe, potentially life-threatening, and fatal skin reactions have been reported in patients taking Intelence. These include cases of Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme, hypersensitivity reactions have also been reported and were characterized by rash, constitutional findings, and sometimes organ dysfunction, including hepatic failure.
In the DUET studies, Grade 3 and 4 rashes were reported in 1.3% of patients receiving Intelence compared to 0.2% of patients in the placebo arm. Discontinuation rate due to rash was 2.2% in patients taking Intelence. Rash occurred most commonly during the first 6 weeks of therapy.
Tibotec Therapeutics, a division of Centocor Ortho Biotech Products, L.P., headquartered in Titusville, New Jersey, is dedicated to delivering innovative virology therapeutics that help healthcare professionals address serious unmet needs in people living with HIV.