About this item:

64 Views | 33 Downloads

Author Notes:

Orlando Immunology Center, Department of Global Health, Emory University Rollins School of Public Health, 1707 N. Mills Avenue, Orlando, 32803, FL, USA.

crolle@oicorlando.com

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Subjects:

Research Funding:

Dr. Charlotte-Paige Rolle has received research grants and honoraria from Gilead Sciences, ViiV Healthcare, Theratechnologies and Janssen Infectious Diseases during the conduct of this study. Dr. Federico Hinestrosa has received honoraria from Gilead Sciences, Merck, and AbbVie during the conduct of this study. Dr. Edwin DeJesus has received honoraria from Gilead Sciences, Theratechnologies, Janssen Pharmaceuticals and ViiV Healthcare during the conduct of this study.

This work was supported by a research grant from Gilead Sciences, IN-US-292-5356 (PI: Rolle).

Keywords:

  • Simplification
  • Multi-tablet regimens
  • Highly treatment experienced

Clinical outcomes of HIV-1 infected patients switched from complex multi-tablet regimens to tenofovir alafenamide based single-tablet regimens plus a boosted protease inhibitor in a real-world setting

Tools:

Journal Title:

Journal of Virus Eradication

Volume:

Volume 6, Number 4

Publisher:

Type of Work:

Article | Final Publisher PDF

Abstract:

Background Multi-tablet regimens (MTRs) are associated with increased adverse events and non-adherence. Single tablet regimens (STRs) plus boosted protease inhibitors (PIs) are a simplification option for MTR-treated patients; however, data is needed to validate this therapeutic strategy. Methods This retrospective analysis included all HIV-1 infected patients seen at a single center from March 2016 to December 2017 who were switched from twice-daily (BID) regimens or regimens containing ​≥ ​3 pills daily to elvitegravir/cobicistat/emtricitabine/tenofovir-alafenamide (E/C/F/TAF) plus darunavir (DRV) or rilpivirine/emtricitabine/tenofovir-alafenamide (RPV/F/TAF) plus DRV boosted with ritonavir or cobicistat (DRV/r-c). Eligible patients had baseline HIV-1 RNA<200 copies/mL and were followed for 48 weeks. The primary endpoint was HIV-1 RNA≥50 copies/mL at Week 48. Adherence and safety data were recorded throughout the study. Results Of 61 patients included, median age was 53 years, the median number of pills taken daily (range) was 5 (3–9), 80% were taking BID regimens, 97% had baseline HIV-1 RNA<50 copies/mL, 56 (92%) were switched to E/C/F/TAF plus DRV and 5 (8%) to RPV/F/TAF plus DRV/r-c. At Week 48, 2 patients (3%) had HIV-1 RNA≥ 50 copies/mL, both were treated with E/C/F/TAF plus DRV and neither had evidence of treatment-emergent resistance. Fifty-nine (97%) had an HIV-1 RNA<50 copies/mL. Adverse drug reactions (ADRs) occurred in 3/61 (5%) (all Grade 2) leading to 3/61 (5%) ADR-related discontinuations. Conclusion In this real-world cohort of MTR-treated patients, switching to a TAF-based STR plus boosted PI maintained virologic control in 97% and was well-tolerated, supporting potential use of this strategy for regimen simplification.

Copyright information:

© 2020 The Authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
Export to EndNote