Dr. Christian Marsolais reports

THERATECHNOLOGIES UNVEILS STUDY DESIGN AND BASELINE CHARACTERISTICS OF PROMISE-US TRIAL OF IBALIZUMAB IN HEAVILY TREATMENT-EXPERIENCED PEOPLE WITH HIV AND MULTIDRUG RESISTANCE

Theratechnologies Inc. has disclosed the study design and baseline characteristics of participants in the prospective observational study of multidrug-resistant patient outcomes with and without ibalizumab in a real-world setting -- United States (Promise-U.S.). The study seeks to fill a critical gap in long-term clinical outcomes for heavily treatment-experienced (HTE) people with HIV (PWH) while illuminating factors contributing to maintenance of virologic control.

In a poster presentation at IDWeek 2024 in Los Angeles, Calif., Promise-U.S. investigators reported that ibalizumab, a CD4-directed postattachment inhibitor of HIV, was more frequently selected for use in advanced, HTE participants with lower CD4 cell counts and higher viral loads, compared with regimens not containing ibalizumab. Despite the use in more advanced patients, ibalizumab demonstrated good durability, with the majority of subjects staying on therapy for more than 24 months.

"The phenomenon of multidrug resistance is most prevalent in persons with HIV with extensive prior exposure to anti-retroviral therapies, making it challenging to establish and maintain virologic control, due to the limited availability of medications for constructing a fully suppressive regimen," stated presenting author Dr. Charlotte-Paige Rolle, MD, MPH, director of research operations, Orlando Immunology Center. "Given the need for more options to treat this subset of PWH and to understand how they respond to treatment, we designed Promise-U.S. to compare the long-term efficacy and safety of ibalizumab-based regimens to other regimens used in heavily treatment-experienced individuals in the real-world setting."

Promise-U.S. (ClinicalTrials.gov identifier No.: NCT05388474) is a phase 4, multicentre, retrospective and prospective, observational, non-interventional registry study. The study is designed to assess risk factors and predictors of virologic and immunologic response in HTE PWH and specific subpopulations and is the first real-world registry study that captures patient-reported outcomes such as satisfaction and adherence to treatment in this specific patient population.

The study's primary objective is to evaluate the long-term efficacy and durability of ibalizumab in combination with other anti-retroviral (ARV) therapies by comparing the clinical outcomes of patients receiving ibalizumab (cohort 2) versus matched patients not receiving ibalizumab (cohort 1).

As of November, 2023, a total of 114 participants were enrolled: 70 in cohort 1, 42 on ibalizumab and two screen failures. Baseline characteristics, including race, ethnicity, sex, gender and time since diagnosis, were well matched between both cohorts. The use of ibalizumab was associated with HTE patients with higher viral loads (p equal to 0.0629) and declining CD4 T cells (p equal to 0.001), compared with those subjects not taking ibalizumab.

The Promise-U.S. researchers also investigated the use of the capsid inhibitor lenacapavir for HTE PWH in combination with ibalizumab. This subset of cohort 2 exhibited the highest viral loads and lowest CD4 counts at baseline, although the sample size is small (n equal to 12). As of the time of analysis, 80 per cent of participants (n equal to 21) in cohort 2 had remained on ibalizumab for greater than 12 months. Ibalizumab was well tolerated, with no infusion reactions reported.

"As more agents with novel mechanisms of action become available and HIV researchers and clinicians are paying increasing attention to multidrug resistance, we continue to analyze data from Promise-U.S. to understand the long-term safety and efficacy of ibalizumab, particularly with regard to its suitability for combination with long-term injectable therapies," said Dr. Christian Marsolais, PhD, senior vice-president and chief medical officer of Theratechnologies. "We also seek further understanding of the factors that contribute to maintaining virologic response in heavily treatment-experienced individuals with HIV, a population with a high unmet need for reliable, sustainable anti-retroviral therapy. We are proud to be the first company to establish a registry to capture long-term clinical outcomes for heavily treatment-experienced patients with multidrug-resistant HIV-1 in a real-world setting and look forward to sharing additional data from this ongoing study."

IDWeek 2024 is the joint annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society of Infectious Diseases Pharmacists.

About Theratechnologies Inc.

Theratechnologies is a biopharmaceutical company focused on the development and commercialization of innovative therapies addressing unmet medical needs.

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