TY - JOUR
T1 - Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: A multicenter observational study
AU - Latini, Alessandra
AU - Fabbiani, Massimiliano
AU - Borghi, Vanni
AU - Sterrantino, Gaetana
AU - Giannetti, Alberto
AU - Lorenzini, Patrizia
AU - Loiacono, Laura
AU - Ammassari, Adriana
AU - Bellagamba, Rita
AU - Colafigli, Manuela
AU - D'Ettorre, Gabriella
AU - Di Giambenedetto, Simona
AU - Antinori, Andrea
AU - Zaccarelli, Mauro
PY - 2016
Y1 - 2016
N2 - Background: Aim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT). Methods: Observational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis. Results: Overall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity. Conclusions: In our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.
AB - Background: Aim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT). Methods: Observational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis. Results: Overall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity. Conclusions: In our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.
KW - Antiretroviral therapy
KW - Darunavir Atazanavir
KW - Dual therapy
KW - Infectious Diseases
KW - Raltegravir
KW - Treatment simplification
KW - Antiretroviral therapy
KW - Darunavir Atazanavir
KW - Dual therapy
KW - Infectious Diseases
KW - Raltegravir
KW - Treatment simplification
UR - http://hdl.handle.net/10807/94824
UR - http://www.biomedcentral.com/bmcinfectdis/
U2 - 10.1186/s12879-016-1703-z
DO - 10.1186/s12879-016-1703-z
M3 - Article
SN - 1471-2334
VL - 16
SP - 401-N/A
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
ER -