Efficacy and durability of two‐ vs . three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort
| العنوان: | Efficacy and durability of two‐ vs . three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort |
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| المؤلفون: | Fabbiani, M., Rossetti, B., Ciccullo, A., Oreni, L., Lagi, F., Celani, L., Colafigli, M., De Vito, A., Mazzitelli, M., Dusina, A., Durante, M., Montagnani, F., Rusconi, S., Capetti, A., Sterrantino, G., D'Ettorre, G., Di Giambenedetto, S., Zanelli, G., Baldin, G., Borghetti, A., Latini, A., Mastroianni, C., Borghi, V., Mussini, C., Cossu, M. V., Giacomelli, A., Formenti, T., Trecarichi, E. M., Torti, C., Madeddu, G., Vecchiet, J., Vignale, F., Giacometti, A. |
| المصدر: | HIV Medicine. 22:843-853 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, antiretroviral therapy, Integrase inhibitor, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, 3-Ring, Gastroenterology, Cohort Studies, chemistry.chemical_compound, Heterocyclic Compounds, Interquartile range, Raltegravir Potassium, Internal medicine, Oxazines, Humans, Medicine, Pharmacology (medical), HIV Integrase Inhibitors, InSTI, dual therapy, treatment discontinuation, virological failure, Heterocyclic Compounds, 3-Ring, Lamivudine, Viral Load, business.industry, Elvitegravir, Health Policy, Raltegravir, Discontinuation, Regimen, Infectious Diseases, Tolerability, chemistry, Dolutegravir, business, medicine.drug |
| الوصف: | The aim of the present study was to compare the efficacy and durability of treatment switch to two-drug (2DR) vs. three-drug (3DR) integrase inhibitor (InSTI)-based regimens in a real-life setting.Within the ODOACRE cohort, we selected adult patients with HIV RNA 50 copies/mL switching to an InSTI-based 2DR or 3DR. Survival analyses were performed to estimate the probability of virological failure (VF, defined as one HIV RNA 1000 copies/mL or two consecutive HIV RNA 50 copies/mL) and treatment discontinuation (TD, defined as any modification, intensification or interruption of the regimen), and to evaluate their predictors.Overall, 1666 patients were included, of whom 1334 (80%) were treated with a 3DR (19.9%, 25.0% and 55.1% elvitegravir-, raltegravir- and dolutegravir-based, respectively) and 332 (20%) with a 2DR (79.2% dolutegravir + lamivudine and 20.8% dolutegravir + rilpivirine). Over a median (interquartile range) follow-up of 100 (52-150) weeks, 52 (3.1%) patients experienced VF with an incidence of 1.5/100 person-year of follow-up (PYFU). The estimated 96-week probability of VF was similar for the 2DR and 3DR groups (2.3% vs. 2.8%, P = 0.53), but it was higher for elvitegravir (4.9%) and raltegravir (5.0%) than for dolutegravir (1.5%) (P = 0.04). Four hundred (24%) patients discontinued their InSTI-based regimen, with an incidence of 11.3/100 PYFU. At 96 weeks, 3DRs showed a higher probability of TD for any reason (20.6% vs. 11.2%, P 0.001) and TD for toxicity (9.0% vs. 6.6%, P = 0.02) when compared with 2DRs. A higher risk of TD for central nervous system toxicity was observed for dolutegravir than for elvitegravir and raltegravir (4.0% vs. 2.5% vs. 0.6%, P = 0.005).In virologically suppressed HIV-infected patients, 2DRs showed an efficacy similar to 3DRs but with better tolerability. |
| تدمد: | 1468-1293 1464-2662 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9a2b1d494573730d50ff33e9b4c962d9Test https://doi.org/10.1111/hiv.13146Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9a2b1d494573730d50ff33e9b4c962d9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14681293 14642662 |
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