Maraviroc (HIV prevention)Other Names: MVC (HIV prevention), Selzentry (HIV prevention) Drug Class: CCR5 Antagonist Molecular Formula: C29 H41 F2 N5 O Registry Number: 376348-65-1 (CAS) Chemical Name: Cyclohexanecarboxamide, 4,4-difluoro-N-((1S)-3-((3-exo)-3-(3-methyl-5-(1-methylethyl)-4H-1,2,4-triazol-4-yl)-8-azabicyclo(3.2.1)oct-8-yl)-1-phenylpropyl)- Chemical Class: Phenylpropylamines Organization: ViiV Healthcare Phase of Development: Oral maraviroc for use as HIV pre-exposure prophylaxis is in Phase II development. (Topical microbicide formulations of maraviroc are in Phase I development.)
(Compound details obtained from ChemIDplus Advanced,1 Antimicrobial Agents and Chemotherapy article,2 Selzentry Full Prescribing Information,3 Treatment Action Group 2017 Pipeline Report,4 and ClinicalTrials.gov5,6)
What is maraviroc?
Maraviroc belongs to a group of HIV drugs called antagonists.3 CCR5 antagonists work by attaching to the CCR5 co- on the surface of the immune cells. When maraviroc attaches to the CCR5 co-receptor, certain strains of HIV—called —cannot attach to, enter, or infect the cell.2 This prevents HIV from multiplying and can reduce the amount of HIV in the body.
Some studies have shown that the oral form of maraviroc is quickly absorbed by the body and accumulates in the tissues of the vagina, , and rectum. Because of this, oral maraviroc has been studied as a possible medicine for HIV (PrEP). For more information on PrEP, see the Pre-Exposure Prophylaxis fact sheet.4,7–9
Other forms of maraviroc, including an ring (IVR) and a gel, are in Phase I studies for HIV prevention.4,5,10
Which clinical trials are studying maraviroc?
Oral Maraviroc for HIV Prevention
Study Names: HPTN 069/A5305 (NEXT PrEP); NCT01505114
Status: This study has been completed.
Location: United States and Puerto Rico
Purpose: The purpose of this study was to compare the safety and tolerability of four different medicine regimens for HIV PrEP. The study included two groups of people who were at risk for acquiring HIV infection: women and men who have sex with men ( ).6
- MVC-PrEP (NCT01749566), a Phase I study that evaluated maraviroc concentrations and immune cells in the blood and genital tracts of participants before, during, and after they received maraviroc.11
- MARAVIPREX (NCT01719627), a Phase I study that used rectal mucosa samples from men without HIV to see whether a single of maraviroc could help prevent HIV infection in a laboratory setting.12
- A Phase IV study that evaluated the effect of a single dose of maraviroc using samples of rectal and vaginal tissue from healthy adults without HIV.13
Other forms of maraviroc have been studied in Phase I trials.4,5,9 These include a maraviroc-only IVR, an IVR that contains maraviroc and the investigational drug dapivirine, an IVR that contains maraviroc and the HIV medicine emtricitabine/tenofovir disoproxil fumarate (brand name: Truvada), and a maraviroc gel that can be administered rectally or vaginally.4,5,9,14
What side effects might maraviroc cause?
One goal of HIV research is to identify new drugs that have fewer side effects. In the HPTN 069 (NCT01505114) study discussed under the previous question, the safety of the three regimens that contained oral maraviroc was comparable to the safety of Truvada (the HIV medicine that is approved by the FDA for PrEP).15 In the group of women, approximately one-third of participants had discontinued study treatment by Week 48 of the study for various reasons.16
Side effects that were observed during this study included lower-than-normal blood levels of the electrolyte phosphate (hypophosphatemia), upper respiratory tract infection, headache, and urinary tract infections. Side effects that were related to thesystem or to the included diarrhea, nausea, vomiting, unintentional weight loss, and increased creatinine levels.15,17
Because maraviroc is still being studied, information on possible side effects of the drug is not complete. As testing of maraviroc continues, additional information on possible side effects will be gathered.
Where can I get more information about clinical trials studying maraviroc?
- United States National Library of Medicine. ChemIDplus Advanced: Maraviroc. https://chem.nlm.nih.gov/chemidplus/rn/376348-65-1. Accessed June 18, 2019
- Asin-Milan O, Sylla M, El-Far M, et al. Synergistic combinations of the CCR5 inhibitor VCH-286 with other classes of HIV-1 inhibitors. Antimicrob Agents Chemother. 2014;58(12):7565-7569.
- ViiV Healthcare Company. Selzentry: full prescribing information, November 2016. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=46f30ac5-c96b-429e-976d-8c5ee1c0761b. Accessed June 18, 2019
- Frick M, Gaudino A, Harrington M, et al. Treatment Action Group. 2017 pipeline report. http://www.pipelinereport.org/sites/default/files/2017%20Pipeline%20Report%20Final.pdf. Published July 2017. Accessed June 18, 2019
- International Partnership for Microbicides, Inc. CHARM-03: A randomized, open label, crossover Phase 1 safety and pharmacokinetic study of oral maraviroc and maraviroc 1% gel administered rectally and vaginally to HIV-1 seronegative adults. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 20, 2015. NLM Identifier: NCT02346084. https://clinicaltrials.gov/ct2/show/NCT02346084. Accessed June 18, 2019
- National Institute of Allergy and Infectious Diseases (NIAID). A Phase II randomized, double-blind, study of the safety and tolerability of maraviroc (MVC), maraviroc + emtricitabine (MVC+FTC), maraviroc + tenofovir disoproxil fumarate (MVC+TDF), or tenofovir disoproxil fumarate + emtricitabine (TDF+FTC) for pre-exposure prophylaxis (PrEP) to prevent HIV transmission in at-risk men who have sex with men and in at-risk women. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 4, 2012. NLM Identifier: NCT01505114. https://clinicaltrials.gov/ct2/show/NCT01505114. Accessed June 18, 2019
- Brown KC, Patterson KB, Malone SA, et al. Single and multiple dose pharmacokinetics of maraviroc in saliva, semen, and rectal tissue of healthy HIV-negative men. J Infect Dis. 2011;203(10):1484-1490.
- Dumond JB, Patterson KB, Pecha AL, et al. Maraviroc concentrates in the cervicovaginal fluid and vaginal tissue of HIV-negative women. J Acquir Immune Defic Syndr. 2009;51(5):546-553.
- Massud I, Aung W, Martin A, et al. Lack of prophylactic efficacy of oral maraviroc in macaques despite high drug concentrations in rectal tissues. J Virol. 2013;87(16):8952-8961.
- Auritec Pharmaceuticals. Open-label safety and pharmacokinetic study of single (TDF), dual (TDF-FTC), and triple ARV IVR (TDF-FTC-MVC) in healthy women. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on August 4, 2014. NLM Identifier: NCT02431273. https://www.clinicaltrials.gov/ct2/show/NCT02431273. Accessed June 18, 2019
- Emory University. Exploring HIV entry blockade as a pre-exposure prophylaxis strategy in women. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on November 9, 2012. NLM Identifier: NCT01749566. https://www.clinicaltrials.gov/ct2/show/NCT01749566. Accessed June 18, 2019
- Fundacio Lluita Contra la SIDA. Pilot study of protection against ex vivo HIV infection in rectal mucosa in health volunteers after administration of maraviroc. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on October 10, 2012. NLM Identifier: NCT01719627. https://www.clinicaltrials.gov/ct2/show/NCT01719627. Accessed June 18, 2019
- Fox J, Herrera C, Tiraboschi JM, et al. A Phase IV PrEP study reveals limited ex vivo potency of oral maraviroc against HIV-1. Abstract presented at: 22nd Conference on Retroviruses and Opportunistic Infections (CROI); February 23-26, 2015; Seattle, WA. Abstract 86LB. http://www.croiconference.org/sessions/phase-iv-prep-study-reveals-limited-ex-vivo-potency-oral-maraviroc-against-hiv-1. Accessed June 18, 2019
- Chen BA, Panther L, Marzinke MA, et al. Phase 1 safety, pharmacokinetics, and pharmacodynamics of dapivirine and maraviroc vaginal rings: a double-blind randomized trial. J Acquir Immune Defic Syndr. 2015;70(3):242-249.
- Gulick R. HPTN 069 / ACTG A5305: Phase II study of maraviroc (MVC)-containing regimens for HIV PrEP in men who have sex with men (MSM). 23rd Conference on Retroviruses and Opportunistic Infections (CROI); February 22-25, 2016; Boston, MA. Levin: Conference reports for National AIDS Treatment Advocacy Project (NATAP); 2016. http://www.natap.org/2016/CROI/croi_39.htm. Accessed June 18, 2019
- Gulick RM, Wilkin TJ, Chen YQ, et al. Phase 2 safety and tolerability study of maraviroc-containing regimens to prevent HIV infection in women (HPTN 069/ACTG A5305): a randomized trial. Ann Intern Med. 2017;167(6):384-393.
- Gulick RM. HPTN 069/ACTG A5305 Phase II study of maraviroc (MVC)-containing regimens for HIV PrEP in U.S. women. 21st International AIDS Conference (AIDS 2016); July 18-22, 2016; Durban, South Africa. Levin: HPTN 069 / ACTG A5305 Phase II Study of Maraviroc (MVC)-Containing Regimens for HIV PrEP in U.S. Women...."NO new infections....annual incidence rate 0%"; Conference Reports for National AIDS Treatment Advocacy Project (NATAP); 2016. http://www.natap.org/2016/IAC/IAC_15.htm. Accessed June 18, 2019
Last Reviewed: June 11, 2019
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