Trial on Efficacy and Safety of Pritelivir Tablets for Treatment of Acyclovir-resistant Mucocutaneous HSV (Herpes Simplex Virus) Infections in Immunocompromised Subjects

Last updated: March 10, 2025
Sponsor: AiCuris Anti-infective Cures AG
Overall Status: Active - Recruiting

Phase

3

Condition

N/A

Treatment

Foscarnet

Pritelivir

Investigator's choice

Clinical Study ID

NCT03073967
AIC316-03-II-01
  • Ages > 16
  • All Genders

Study Summary

Randomized, open-label, multi-center, comparative trial to assess the efficacy and safety in immunocompromised subjects with acyclovir resistant or acyclovir susceptible mucocutaneous HSV infection, treated with pritelivir 100 mg once daily (following a loading dose of 400 mg as first dose to rapidly reach steady-state plasma concentration) or investigators choice, which can be either foscarnet 40 mg/kg every 8 hours or 60 mg/kg every 12 hours, or Cidofovir iv 5 mg/kg body weight given once weekly, or Cidofovir 1% or 3% topical applied 2 to 4 times daily, or Imiquimod 5% topical 3 times per week) (provided the drug is nationally approved).

Eligibility Criteria

Inclusion

Part C inclusion criteria

  1. Immunocompromised men and women of any ethnic group aged ≥16 years.

In Canada, Germany, Belgium:

Immunocompromised (due to conditions including but not limited to HIV infection, hematopoietic cell or solid organ transplantation, and chronic use of immunosuppressive treatment) men and women of any ethnic group aged >18 years.

  1. ACV-R mucocutaneous HSV infection based on clinical failure or positive genotypic/phenotypic ACV resistance testing for current lesion. Clinical failure is defined as no improvement after oral or iv doses for at least 7 days at doses equivalent to or greater than the local agency approved high oral doses of acyclovir, valacyclovir or famciclovir.

  2. Lesions accessible for visual inspection to allow assessment of lesion healing including visualization by endoscopy.

  3. Willingness to use highly effective birth control.

  4. Subject, and/or their legally authorized representative, (proxy consent is not permitted in Germany), must be willing and able to understand the Informed Consent Form.

  5. Negative serum β-HCG (beta-human chorionic gonadotropin) test for women of child-bearing potential at Screening and a negative urine pregnancy test at Day 1.

  6. Written informed consent. For subjects, who are unable to provide informed consent for whatever reason, written consent must be obtained from the legal representative, (proxy consent is not permitted in Germany).

Part D and F inclusion criteria

All inclusion criteria as for Part C, except for inclusion criterion 2, which is replaced by:

  1. ACV-R and foscarnet-R mucocutaneous HSV infection based on clinical failure or positive genotypic/phenotypic resistance testing for current lesion or documented intolerance to iv foscarnet requiring cessation of foscarnet treatment or precluding foscarnet treatment.

Subjects will be able to enter Part F only after closure of enrollment in Part D.

Part E inclusion (Part E is not being conducted in Germany)

All inclusion criteria as for Part C, except for inclusion criterion 2, which is replaced by:

  1. Recurrent mucocutaneous HSV infection considered ACV-S.

Part C exclusion criteria

  1. Known resistance/intolerance to pritelivir or any of the excipients.

  2. Previous treatment in PRIOH-1.

  3. Baseline safety laboratory abnormalities.

  4. History or current evidence of gastrointestinal malabsorption which, in the opinion of the Investigator, may affect the extent of absorption of pritelivir.

  5. Hemodialysis for any indication and ESRD (eGFR <15 mL/min; stage 5 CKD)

  6. History or current evidence of significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, hematological, endocrinological, metabolic, neurological, psychiatric, or other relevant diseases.

  7. Abnormalities in hematological, clinical chemical or any other laboratory variables.

  8. Not able to communicate meaningfully with the Investigator and site staff.

  9. Any other condition which in the opinion of the Investigator would interfere with successful completion of this clinical trial.

  10. Any other important local condition.

  11. Pregnant and/or breastfeeding women.

  12. Having received an investigational drug in an investigational drug trial unter certain conditions.

Part D (complete) exclusion criteria

All exclusion criteria as for Part C, except criterion 12, which is replaced by:

  1. Having received an investigational drug in an investigational trial within 7 half-lives after the last administration of this drug before initiating trial medication, except for subjects entering Part D, who have previously received foscarnet treatment in Part C of this trial.

Participation in a clinical trial without receiving other investigational drugs (eg, follow-up phase of a trial, observational study) is permitted.

Part E exclusion criteria (Part E is not being conducted in Germany)

All exclusion criteria in Part E are identical to those in Part C with the addition of:

  1. Having used acyclovir, valacyclovir, or famciclovir within 3 days prior to starting pritelivir.

Part F exclusion criteria All exclusion criteria for Part D plus 13. Part D open for enrollment

Study Design

Total Participants: 153
Treatment Group(s): 3
Primary Treatment: Foscarnet
Phase: 3
Study Start date:
May 08, 2017
Estimated Completion Date:
November 30, 2025

Study Description

The trial comprises 5 Parts, Part A, B, C, D, E and F.

Part A and Part B (Phase 2) have been finalised.

  • Part A is a randomized, open-label, multi-center, comparative design to assess the efficacy and safety in subjects with ACV-resistant mucocutaneous HSV infection, treated with oral pritelivir or intravenous foscarnet.

  • Part B is an open-label, multi-center design to assess the efficacy and safety of pritelivir in subjects with ACV-resistant-mucocutaneous HSV and who either:

    1. present with foscarnet-resistance/intolerance, or

    2. developed foscarnet resistance/intolerance during treatment in Part A (no improvement after at least 5 days of foscarnet therapy or intolerance to foscarnet requiring cessation of foscarnet treatment).

      Parts C, D, E and F (Phase 3).

  • Part C is a randomized, open-label, multi-center, comparative design to assess the efficacy and safety of oral pritelivir in subjects with acyclovir resistent (ACV-R) mucocutaneous HSV episodes. Subjects with ACV-R mucocutaneous HSV infection will be randomized 1:1 to receive either oral pritelivir or Investigator's Choice.

This trial part is designed to show superiority of pritelivir against Investigator's Choice in obtaining clinical cure, ie, number of subjects with all lesions healed within 28 days.

  • Part D is an open-label, multi-center design to assess the efficacy and safety of pritelivir in subjects with ACV-R mucocutaneous HSV episodes and who in addition either:

    1. present with iv foscarnet resistance/intolerance already at Screening for inclusion, or

    2. developed foscarnet resistance/intolerance during treatment in Part C (no improvement after at least 7 days of foscarnet treatment or intolerance to foscarnet requiring cessation of foscarnet treatment). Part D has been closed in June 2022.

  • Part E is an open-label, multi-center design to assess the safety and efficacy of pritelivir in subjects with acyclovir susceptible (ACV-S) mucocutaneous HSV episodes, (Part E is not being conducted in Germany).

  • Part F is an open-label, multi-center design to assess the efficacy and safety of pritelivir in subjects with ACV-R mucocutaneous HSV episodes and who in addition either:

    1. present with iv foscarnet resistance/intolerance already at Screening for inclusion, or

    2. developed foscarnet resistance/intolerance during treatment in Part C (no improvement after at least 7 days of foscarnet treatment or intolerance to foscarnet requiring cessation of foscarnet treatment).

    3. cannot be enrolled into Part D anymore because enrollment into Part D has been completed.

Dosing of trial medication:

Pritelivir oral tablet as single daily doses of 100 mg (following a loading dose of 400 mg as first dose)

Comparator per investigator's choice (provided the drug listed below is nationally approved):

Foscarnet intermittent infusions of 40 mg/kg every 8 hours or 60 mg/kg every 12 hours (to be adjusted in case of renal impairment) for a minimum of 1 hour duration, or Cidofovir iv infusion of 5 mg/kg body weight given once weekly, or Cidofovir 1% or 3% topical treatment, applied 2 to 4 times daily, or Imiquimod 5% topical treatment, 3 times per week.

Duration of treatment:

Until all mucocutaneous HSV lesions are healed or up to 28 days, whichever is earlier.

A prolongation up to a maximum of 42 days may be possible depending on the clinical progress.

Connect with a study center

  • Hospital Rawson

    Córdoba, 5000
    Argentina

    Active - Recruiting

  • Sanatorio Mayo Privado S.A.

    Córdoba, 5000
    Argentina

    Active - Recruiting

  • Instituto FIDES

    La Plata, CP 1900
    Argentina

    Active - Recruiting

  • Melbourne Health - Royal Melbourne Hospital

    Parkville, 3050
    Australia

    Active - Recruiting

  • Westmead Hospital, Centre for Infectious Disease and Microbiology

    Westmead, 2145
    Australia

    Active - Recruiting

  • AZ Sint-Jan Brugge

    Brugge, 8000
    Belgium

    Active - Recruiting

  • Centre Hospitalier Universitaire Saint Pierre

    Brussels, B1000
    Belgium

    Suspended

  • AZ Delta

    Roeselare, 8800
    Belgium

    Active - Recruiting

  • Alberta Health Services Cross Cancer Institute at the University of Alberta

    Edmonton, Alberta T6G 1Z2
    Canada

    Active - Recruiting

  • Beijing Ditan Hospital Capital Medical University

    Beijing, 100015
    China

    Site Not Available

  • CHU Limoges - Centre national de reference des Herpes virus

    Limoges, 87042
    France

    Active - Recruiting

  • CHU de Nantes

    Nantes, 44093
    France

    Active - Recruiting

  • AP-HP Hopital Bichat - Claude Bernard

    Paris, 75018
    France

    Active - Recruiting

  • AP-HP Hopital Necker-Enfants Malades

    Paris, 75015
    France

    Active - Recruiting

  • Hôpital Saint Louis - AP-HP

    Paris, 75010
    France

    Active - Recruiting

  • JSC Curatio

    Tbilisi, 0168
    Georgia

    Active - Recruiting

  • LLC Diakor

    Tbilisi, 0159
    Georgia

    Active - Recruiting

  • Multiprofile Clinic Consilium Medulla LTD

    Tbilisi, 0186
    Georgia

    Suspended

  • Universitätsklinikum Essen

    Essen, 45147
    Germany

    Active - Recruiting

  • Universitätsklinikum Köln

    Köln, 50937
    Germany

    Active - Recruiting

  • Universitaetsmedizin Mannheim, III. Medizinische Klinik

    Mannheim, 68167
    Germany

    Site Not Available

  • Muenchen Klinik Neuperlach

    Muenchen, 81737
    Germany

    Site Not Available

  • Universitätsklinikum Würzburg

    Würzburg, 97080
    Germany

    Active - Recruiting

  • General Hospital of Athens - Laiko

    Athens, 11527
    Greece

    Active - Recruiting

  • Regional University General Hospital of Heraklion

    Heraklion, 71110
    Greece

    Active - Recruiting

  • Chaim Sheba Medical Center

    Tel-Hashomer, 5265601
    Israel

    Suspended

  • Grande Ospedale Metropolitano "Bianchi Melacrino Morelli"

    Calabria, 89133
    Italy

    Suspended

  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano

    Milano, 20122
    Italy

    Active - Recruiting

  • Fondazione IRCCS Policlinico San Matteo

    Pavia, 27100
    Italy

    Active - Recruiting

  • Unidad de Investigacion CIMA SC

    Chihuahua, 64718
    Mexico

    Active - Recruiting

  • Centro de Investigacion Clinica GRAMEL S.C.

    Distrito Federal, 03720
    Mexico

    Active - Recruiting

  • Instituto de Investigaciones Aplicadas a la Neurociencia A.C

    Durango, 34000
    Mexico

    Active - Recruiting

  • Centro de Investigacion Farmaceutica Especializado de Occidente S.C.

    Guadalajara, 44160
    Mexico

    Active - Recruiting

  • Unidad de Investigacion CIMA SC

    Monterrey, 64718
    Mexico

    Site Not Available

  • Clinical Research Institute Saltillo S.A de C.V

    Saltillo, 25020
    Mexico

    Site Not Available

  • Arke SMO S.A. de C.V.

    Veracruz, 91910
    Mexico

    Active - Recruiting

  • Universitaetsspital Basel

    Basel, 4031
    Switzerland

    Active - Recruiting

  • Universitaetsspital Basel Ambulantes Studienzentrum

    Basel, 4031
    Switzerland

    Site Not Available

  • Hopitaux universitaires de Geneve

    Genève, 1205
    Switzerland

    Active - Recruiting

  • Universitaetsspital Zuerich

    Zuerich, 8091
    Switzerland

    Active - Recruiting

  • Nhs Lothian

    Edinburgh, EH4 2XU
    United Kingdom

    Active - Recruiting

  • Chelsea and Westminster Hospital

    London, SW109NH
    United Kingdom

    Active - Recruiting

  • Research Department of Haematology, UCL Cancer Institute

    London, WC1E 6BT
    United Kingdom

    Active - Recruiting

  • Freeman Hospital

    Newcastle Upon Tyne, NE7 7DN
    United Kingdom

    Active - Recruiting

  • University of Alabama at Birmingham

    Birmingham, Alabama 35205
    United States

    Active - Recruiting

  • University of South Alabama

    Mobile, Alabama 36604
    United States

    Active - Recruiting

  • University Arizona - Department of Medicine Arizona Health Sciences Center

    Tucson, Arizona 85724
    United States

    Active - Recruiting

  • City of Hope

    Duarte, California 91010
    United States

    Active - Recruiting

  • Cedars-Sinai Medical Center

    Los Angeles, California 90048
    United States

    Active - Recruiting

  • University of California, Division of Infectious Diseases

    Sacramento, California 95817
    United States

    Active - Recruiting

  • IMMUNOe International Research Centers

    Centennial, Colorado 80112
    United States

    Site Not Available

  • Yale University School of Medicine - Infectious Diseases

    New Haven, Connecticut 06510
    United States

    Site Not Available

  • Geogetown University Hospital

    Washington, District of Columbia 20007
    United States

    Site Not Available

  • Midland Florida Clinical Research Center, LLC

    DeLand, Florida 32720
    United States

    Active - Recruiting

  • Midway Immunology and Research Center (MIRC)

    Fort Pierce, Florida 34982
    United States

    Active - Recruiting

  • University of Florida (UF) - Division of Infectious Disease

    Gainesville, Florida 32610
    United States

    Active - Recruiting

  • Links Clinical Trials

    Miami, Florida 33176
    United States

    Active - Recruiting

  • Palmetto Professional Research

    Miami, Florida 33175
    United States

    Active - Recruiting

  • Comprehensive Care Center dba Community AIDs Network

    Sarasota, Florida 34237
    United States

    Site Not Available

  • Florida Health Sciences Center/Tampa General Hospital/USF

    Tampa, Florida 33606
    United States

    Site Not Available

  • Emory Hospital Midtown Infectious Disease Clinic

    Atlanta, Georgia 30308
    United States

    Active - Recruiting

  • Department of Medicine J. H. Stroger Hospital of Cook County

    Chicago, Illinois 60612
    United States

    Active - Recruiting

  • Indiana University (IU) Infectious Diseases Research

    Indianapolis, Indiana 46202
    United States

    Site Not Available

  • LSU Health Baton Rouge Pulmonary Clinic

    Baton Rouge, Louisiana 70809
    United States

    Active - Recruiting

  • Tulane University - School of Medicine

    New Orleans, Louisiana 70112
    United States

    Active - Recruiting

  • Johns Hopkins University School of Medicine

    Baltimore, Maryland 21205
    United States

    Active - Recruiting

  • Brigham and Women's Hospital

    Boston, Massachusetts 02115
    United States

    Active - Recruiting

  • Massachusetts General Hospital

    Boston, Massachusetts 02114
    United States

    Active - Recruiting

  • Wayne State University

    Detroit, Michigan 48201
    United States

    Site Not Available

  • University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Active - Recruiting

  • University of Nebraska Medical Center

    Omaha, Nebraska 68198
    United States

    Active - Recruiting

  • Rutgers Robert Wood Johnson Medical School

    New Brunswick, New Jersey 08901
    United States

    Active - Recruiting

  • Kings Country Hospital Center

    Brooklyn, New York 11203
    United States

    Active - Recruiting

  • SUNY Downstate Medical Center

    Brooklyn, New York 11203
    United States

    Site Not Available

  • David H. Koch Center at Memorial Sloan Kettering Cancer Center

    New York, New York 10021
    United States

    Active - Recruiting

  • Duke University Medical Center - Division of Infectious Diseases

    Durham, North Carolina 27710
    United States

    Active - Recruiting

  • Atrium Health Wake Forest Baptist

    Winston-Salem, North Carolina 27157
    United States

    Active - Recruiting

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio 45229
    United States

    Active - Recruiting

  • Penn State Health Milton S. Hershey Medical Center

    Hershey, Pennsylvania 17033
    United States

    Active - Recruiting

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania 15232
    United States

    Active - Recruiting

  • MD Anderson Cancer Center

    Houston, Texas 77030-4009
    United States

    Active - Recruiting

  • Fred Hutchinson Cancer Research Center

    Seattle, Washington 98109
    United States

    Active - Recruiting

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