التفاصيل البيبلوغرافية
| العنوان: |
A Nucleoside- and Ritonavir-Sparing Regimen Containing Atazanavir Plus Raltegravir in Antiretroviral Treatment-Naïve HIV-Infected Patients: SPARTAN Study Results. |
| المؤلفون: |
Kozal, Michael J., Lupo, Sergio, DeJesus, Edwin, Molina, Jean-Michel, McDonald, Cheryl, Raffi, Francois, Benetucci, Jorge, Mancini, Marco, Yang, Rong, Wirtz, Victoria, Percival, Lisa, Zhang, Jenny, Zhu, Li, Arikan, Dilek, Farajallah, Awny, Nguyen, Bach-Yen, Leavitt, Randi, McGrath, Donnie, Lataillade, Max, the SPARTAN Study Team |
| المصدر: |
HIV Clinical Trials; May/Jun2012, Vol. 13 Issue 3, p119-130, 12p |
| مستخلص: |
Background: Nucleoside and ritonavir (RTV) toxicities have led to increased interest in nucleoside reverse transcriptase inhibitors (NRTIs) and RTV-sparing antiretroviral regimens. SPARTAN was a multicenter, randomized, open-label, noncomparative pilot study evaluating the efficacy, safety, and resistance profile of an investigational NRTI- and RTV-sparing regimen (experimental atazanavir [ATV] dose 300 mg bid + raltegravir [RAL] 400 mg bid [ATV+RAL]). The reference regimen consisted of ATV 300 mg/RTV 100 mg qd + tenofovir (TDF) 300 mg/emtricitabine (FTC) 200 mg qd (ATV/r+TDF/FTC). Methods: Treatment-naïve HIV-infected patients with HIV-RNA ≥⃒5,000 copies/mL were randomized 2:1 to receive twice-daily ATV+RAL (n=63) or once-daily ATV/r+TDF/FTC (n=31). Efficacy at 24 weeks was determined by confirmed virologic response (CVR; HIV-RNA <50 copies/mL) with noncom-pleters counted as failures based on all treated subjects. Results: The proportion of patients with CVR HIV RNA <50 copies/mL at week 24 was 74.6% (47/63) in the ATV+RAL arm and 63.3% (19/30) in the ATV/r+TDF/FTC arm. Systemic exposure to ATV in the ATV+RAL regimen was higher than historically observed with ATV/r+TDF/ FTC. Incidence of Grade 4 hyperbilirubinemia was higher on ATV+RAL (20.6%; 13/63) than on ATV/r+TDF/FTC (0%). The criteria for resistance testing (virologic failure [VF]: HIV-RNA ≥⃒400 copies/mL) was met in 6/63 patients on ATV+RAL, and 1/30 on ATV/r+TDF/FTC; 4 VFs on ATV+RAL developed RAL resistance. Conclusions: ATV+RAL, an experimental NRTI- and RTV-sparing regimen, achieved virologic suppression rates comparable to current standards of care for treatment-naïve patients. The overall profile did not appear optimal for further clinical development given its development of resistance to RAL and higher rates of hyperbilirubinemia with twice-daily ATV compared with ATV/RTV. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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