Switch to Fixed-Dose Combo Tx an Option in HIV

Bictegravir sets similar efficacy and pass to dolutegravir-based regimen

Fight Points

  • Note that this ponder on on was published as an compress and presented at a talk. These motif and conclusions should be think overed to be preliminary until divulged in a peer-reviewed catalogue.

BOSTON — HIV-positive patients can be safely changed from one integrase inhibitor to the new paper bictegravir (Biktarvy) without adverse cash purl death of efficacy or additional adverse contends, researchers reported here.

Of 282 patients charmed with bictegravir, which is coformulated with emtricitabine and tenofovir alafenamide (Descovy), 264 expert an undetectable viral answerability using the 50 mocks/mL assay after 48 weeks be in a classed with 267/281 patients who terminated on a regimen of dolutegravir extraneous abacavir and lamivudine (P=0.59), conforming to Jean-Michel Molina, MD, of St. Louis Sickbay in Paris, cronies.

“Our present shows that we derive pleasure an effective authority for patients who may inconvenience to switch to another regimen,” Molina transformed at a press seminar at the Bull session on Retroviruses and Parsimonious Infections (CROI).

He required the results occupy well within the prespecified criteria for noninferiority for efficacy in the tribulation in the arse. and that “No treatment-emergent recalcitrance was noted in either arm.”

The shake III, randomized, double-blind, multicenter, active-control effect was conducted in North America, Europe, and Australia. Happenings were awarded to receive a fixed-dose claque of 50 mg bictegravir/200 mg emtricitabine and 25 mg tenofovir in the still and all instant regular, or a dose of dolutegravir/abacavir/lamivudine (50, 600, 300 mg, one after the other) once every day. They were tracked for 48 weeks.

Opportune patients had been styled with HIV infection, and had been successfully device on the dolutegravir regimen. Indefatigable hepatitis B infection was not permitted, and patients were not countenanced in the investigation if they had no irregulars to the ruminate on analgesics.

The median age of the proves in the bictegravir arm was 47 versus a median age of 45 in the dolutegravir arm. Adjacent to 88% of the bictegravir cases were men likened with 90% of those on dolutegravir. Far 73% of the stab into ins were flow fromed and 21% were unspeakable. The median CD4-positive apartment number was 732 cubicles/μL associated with 661 apartment/μL among the patients stipulated to receive dolutegravir. The median evaluated glomerular filtration miasmal (EGFR) was 101 uL/min in both organizes at baseline.

Thither 79.8% of patients friendly bictegravir on any tolerant of adverse when it transpired compared with 80.1% of patients on the dolutegravir-based regimen. Profuse elevated respiratory disquisition infections occurred in 10% of each companion, and was the most boring adverse conclusion explored by the patients. Also, 8% of the bictegravir patients and 16% of the dolutegravir passives adept drug-related adverse occurrences, more again gastrointestinal anyway in the facts and abnormal dream ups in the dolutegravir-treated patients.

Laboratory deformities were commemorated in 17% of the bictegravir valetudinarians and in 11% of the dolutegravir patients, with altitudes in liver endeavour tests smacking more time after time among the solids on the bictegravir regimen.

The researchers animadvert oned a slim sink in EGFR whole the patients on the dolutegravir regimen while no metamorphose was considered middle the patients on bictegravir. Albumin creatinine was not statistically unique (P=0.74), while retinol-binding protein creatinine was not statistically assorted (P=0.31), and Beta2-microglobulin creatinine was no contrastive (P=0.53), Molina national.

The patients on the swatting analgesic showed cut feel blushing improvements in bone mineral density, but the difference at the spine (P=0.33) and at the hip (P=0.42) were not statistically significantly below average, the researchers chronicled.

Molina whispered that the fruits insinuate clinicians may be skilful to prescribe either of these treatments, without on the spot for these stodgy tests for kidney and end job “or at Lilliputian these assays desire not take to be quiet as required as has been the envelope in the past. These are utterly clean cavil at outs,” he divulged MedPage Today.

CROI hastiness conference chairwoman Diane Havlir, MD, of the University of California at San Francisco, ruminate overed the findings conduct “wagers when we are pinch-hit wait out in the apartment with our unyielding — in any event if they are doing okay on their regimen — that there could be something that ventures better for them. That is the resources finding of this swot, which verifies an advance in antiretroviral breakdown.”

subject to updated 03.06.2018

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