Drugs

Monomeric DAPTA

Monomeric DAPTA

Other Names: Adaptavir, D-Ala1-peptide T-amide, DAPTA, Peptide T, RAP101, mDAPTA, monomeric D-Ala-peptide T-amide Drug Class: Entry Inhibitor Molecular Formula: C35 H56 N10 O15 Registry Number: 106362-34-9 (CAS) Chemical Name: (D-Ala1) Peptide T Amide; DAPTA  Chemical Class: Peptides Organization: RAPID Pharmaceuticals Phase of Development: II


(Compound details obtained from ChemIDplus Advanced,1 NIAID Therapeutics Database,2 and RAPID Pharmaceuticals press release3)

What is an investigational drug?

What is an investigational drug?

An investigational drug is one that is under study and is not approved by the U.S. Food and Drug Administration (FDA) for sale in the United States. Medical research studies are conducted to evaluate the safety and effectiveness of an investigational drug. These research studies are also called clinical trials. Once an investigational drug has been proven safe and effective in clinical trials, FDA may approve the drug for sale in the United States.

To learn more about investigational drugs, read the AIDSinfo What is an Investigational HIV Drug? fact sheet.

What is monomeric DAPTA?

What is monomeric DAPTA?

Monomeric DAPTA (mDAPTA) is an investigational drug that has been studied for its ability to eliminate HIV infection that persists despite treatment with antiretroviral therapy (ART). (ART is the recommended treatment for HIV infection and involves using a combination of different antiretroviral [ARV] drugs to prevent HIV from replicating.) Currently, ART can reduce the level of HIV in the blood to an undetectable level, but it can't eliminate HIV entirely from the body.4,5

mDAPTA belongs to a class (group) of HIV drugs called entry and fusion inhibitors.2 Entry and fusion inhibitors block HIV from getting into and infecting certain cells of the immune system. This prevents HIV from multiplying and can reduce the amount of HIV in the body.

mDAPTA works by attaching to a protein on the surface of the immune cells. The protein is called the CCR5 co-receptor. When mDAPTA attaches to the CCR5 co-receptor, certain strains of HIV—called R-5 tropic virus—cannot attach to, enter, or infect the cell.6

mDAPTA is also currently being studied to treat progressive multifocal leukoencephalopathy (PML). PML is a viral infection of the central nervous system (brain and spinal cord). PML can occur in people with a weakened immune system, including people with advanced HIV infection or AIDS.7

The main component of mDAPTA is peptide T. Peptide T was an investigational drug that was previously studied to test its ability to reduce the amount of HIV in the body and bolster the immune system. The drug’s effect on HIV-associated cognitive impairment was also studied. (Cognitive impairment is when people have trouble remembering, learning new things, concentrating, or making decisions that affect their everyday lives.)5,8,9

How are clinical trials of investigational drugs conducted?

How are clinical trials of investigational drugs conducted?

Clinical trials are conducted in phases. Each phase has a different purpose and helps researchers answer different questions.10

  • Phase I trials: Researchers test an investigational drug in a small group of people (20–80) for the first time. The purpose is to evaluate its safety and identify side effects.
  • Phase II trials: The investigational drug is administered to a larger group of people (100–300) to determine its effectiveness and to further evaluate its safety.
  • Phase III trials: The investigational drug is administered to large groups of people (1,000–3,000) to confirm its effectiveness, monitor side effects, compare it with standard or equivalent treatments, and collect information that will allow the investigational drug to be used safely.10

In most cases, an investigational drug must be proven effective and must show continued safety in a Phase III clinical trial to be considered for approval by FDA for sale in the United States. Some drugs go through FDA’s accelerated approval process and are approved before a Phase III clinical trial is complete. After a drug is approved by FDA and made available to the public, researchers track its safety in Phase IV trials to seek more information about the drug’s risks, benefits, and optimal use.10

Some clinical trials are categorized as “a” or “b,” such as “Phase Ia” or “Phase IIb.” These different subphases typically mean that a study is researching certain types of information or using a certain type of participant population.

In what phase of testing is monomeric DAPTA?

In what phase of testing is monomeric DAPTA?

mDAPTA has been studied in Phase II clinical trials for eliminating HIV infection that persists despite treatment with antiretroviral therapy (ART).2,4

What are some studies on monomeric DAPTA?

What are some studies on monomeric DAPTA?

Peptide T (base compound of mDAPTA)

Study Name: Not available
Sponsor: Not available
Phase: Not available
Location: United States
Participants:

  • The study involved people who had been infected with HIV for many years and who had viral load levels (the amount of HIV in the blood) that were relatively unchanged over 3 weekly measurements.
  • Participants included people who had never taken HIV medicines and people who had taken HIV medicines before.
Purpose: The purpose of this study was to examine the ability of peptide T to reduce viral load levels, improve immune function, and reduce HIV replication in blood monocytes (a type of white blood cell that can be infected by HIV).8

 

Study Name: NCT00000392
Sponsor: National Institute of Mental Health (NIMH)
Phase: II
Location: United States
Participants:
  • The study involved HIV-infected people with cognitive impairment.
  • Participants were required either to have not used HIV medicines within 4 weeks of starting the study or to have had their HIV infection under control with HIV medicines for at least 12 weeks before starting the study.
Purpose: The purpose of this study was to see whether peptide T could improve the cognitive function (such as memory, language, and thinking) of HIV-infected people with cognitive impairment.9,11

 

mDAPTA (the modified version of peptide T)

Study Name: NCT00951743
Sponsor: Rapid Laboratories Inc.
Phase: II
Location: United States
Participants:

  • The study involves HIV-infected adults who have taken HIV medicines for at least 6 months.
  • Participants have viral loads levels of less than 200 copies/mL for at least 3 months before the start of the study.
Purpose: The purpose of this study was to look at the ability of mDAPTA to eliminate HIV that is resistant to current HIV medicines and that hides in certain immune cells. Although these HIV-infected immune cells may be inactive, they can begin to produce HIV at any time.4
* The recruitment status of this study is unknown.

 

For more details on the studies listed above, see the Health Professional version.

What side effects might monomeric DAPTA cause?

What side effects might monomeric DAPTA cause?

In the first study of peptide T discussed under the previous question, there were no side effects associated with peptide T use among the 11 participants.8

In the Phase II cognitive function study (NCT00000392), investigators reported some cases of mood disturbance and rash in the peptide T group that were severe and one case of rash that was life-threatening. (Investigators also reported that some of these cases, especially the mood disturbances, may not have been caused by peptide T use.) Other side effects that occurred in the peptide T group included nasal congestion, abnormal amounts of protein in the urine, and higher than normal amounts of a certain type of white blood cell.9,11 (After these studies were done, peptide T was reformulated as mDAPTA.)

Information on possible side effects of mDAPTA is not complete. As testing of mDAPTA continues, additional information on possible side effects will be gathered.

Where can I get more information about clinical trials studying monomeric DAPTA?

Where can I get more information about clinical trials studying monomeric DAPTA?

More information about mDAPTA-related research studies is available from the AIDSinfo database of ClinicalTrials.gov study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.

How can I find more information about participating in a clinical trial?

How can I find more information about participating in a clinical trial?

Participating in a clinical trial can provide benefits. For example, a volunteer participant can benefit from new research treatments before they are widely available. Participants also receive regular and careful medical attention from a research team that includes doctors and other health professionals. However, clinical trials may also involve risks of varying degrees, such as unpleasant, serious, or even life-threatening side effects from the treatment being studied.10

Your health care provider can help you decide whether participating in a clinical trial is right for you. For more information, visit NIH Clinical Research Trials and You.

 

References

References

  1. United States National Library of Medicine. ChemIDplus Advanced. Available at: https://chem.sis.nlm.nih.gov/chemidplus/rn/106362-34-9. Last accessed on June 29, 2017.
  2. National Institute of Allergy and Infectious Diseases (NIAID). NIAID ChemDB, HIV Drugs in Development. Available at: https://chemdb.niaid.nih.gov/DrugDevelopmentHIV.aspx. Last accessed on June 29, 2017.
  3. RAPID Pharmaceuticals: Press Release, dated March 4, 2014. RAPID Acquires All Peptide T Clinical Data. Available at: http://www.rapidpharma.com/rapid-acquires-all-peptide-t-clinical-data/. Last accessed on June 17, 2015.
  4. Rapid Laboratories Inc. Safety and Efficacy of ADAPTAVIR's Ability to Eliminate Treatment-Resistant Infectious Virus in the Blood Cellular Reservoir (PBMCs) of HIV Patients With Suppressed Plasma Viral Load. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on July 31, 2009. NLM Identifier: NCT00951743. Available at: https://www.clinicaltrials.gov/ct2/show/NCT00951743. Last accessed on June 29, 2017.
  5. RAPID Pharmaceuticals website. Monomeric DAPTA – the long path to discovery. Available at: http://www.rapidpharma.com/en/research-developement/technology-platform/path-to-discovery.html. Last accessed on March 31, 2014.
  6. Polianova MT, Ruscetti FW, Pert CB, Ruff MR. Chemokine receptor-5 (CCR5) is a receptor for the HIV entry inhibitor peptide T (DAPTA). Antiviral Res. 2005 Aug;67(2):83-92. Available at: http://www.researchgate.net/profile/Maria_Polianova/publication/8658079_Update_on_D-ala-peptide_T-amide_%28DAPTA%29_a_viral_entry_inhibitor_that_blocks_CCR5_chemokine_receptors/links/5436af3e0cf2643ab9881308.pdf. Last accessed on June 29, 2017.
  7. RAPID Pharmaceuticals. PML. Available at: http://www.rapidpharma.com/pml-rap-101/. Last accessed on June 14, 2016.
  8. Polianova MT, Ruscetti FW, Pert CB, et al. Antiviral and immunological benefits in HIV patients receiving intranasal peptide T (DAPTA). Peptides. 2003 Jul;24(7):1093-8. Available at: http://www.rapidpharma.com/uploads/media/2003-02_Publication.pdf. Last accessed on March 31, 2014.
  9. Heseltine PN, Goodkin K, Atkinson JH, et al. Randomized Double-blind Placebo-Controlled Trial of Peptide T for HIV-Associated Cognitive Impairment. Arch Neurol. 1998 Jan;55(1):41-51. Available at: http://jamanetwork.com/journals/jamaneurology/fullarticle/773550. Last accessed on June 29, 2017.
  10. National Institutes of Health (NIH). NIH Clinical Research Trials and You. Available at: http://www.nih.gov/health-information/nih-clinical-research-trials-you. Last accessed on June 29, 2017.
  11. National Institutes of Mental Health (NIMH). Phase II Study of the Efficacy of Peptide T in HIV-Positive Individuals with Cognitive Impairment. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 17, 2000. NLM Identifier: NCT00000392. Available at: https://www.clinicaltrials.gov/ct2/show/NCT00000392. Last accessed on June 29, 2017.

Last Reviewed: June 29, 2017