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.

Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification. A multicenter observational study / Latini, Alessandra; Fabbiani, Massimiliano; Borghi, Vanni; Sterrantino, Gaetana; Giannetti, Alberto; Lorenzini, Patrizia; Loiacono, Laura; Ammassari, Adriana; Bellagamba, Rita; Colafigli, Manuela; D'Ettorre, Gabriella; Di Giambenedetto, Simona; Antinori, Andrea; Zaccarelli, Mauro. - In: BMC INFECTIOUS DISEASES. - ISSN 1471-2334. - 16:1(2016), pp. 1-7. [10.1186/s12879-016-1703-z]

Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification. A multicenter observational study

D'Ettorre, Gabriella
Conceptualization
;
2016

Abstract

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.
2016
antiretroviral therapy; darunavir atazanavir; dual therapy; raltegravir; treatment simplification; anti-hiv agents; antiretroviral therapy, highly active; cd4 lymphocyte count; darunavir; drug therapy, combination; female; follow-up studies; hiv infections; hiv protease inhibitors; humans; lamivudine; lopinavir; male; medication adherence; middle aged; proportional hazards models; raltegravir potassium; retrospective studies; risk; tenofovir; infectious diseases
01 Pubblicazione su rivista::01a Articolo in rivista
Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification. A multicenter observational study / Latini, Alessandra; Fabbiani, Massimiliano; Borghi, Vanni; Sterrantino, Gaetana; Giannetti, Alberto; Lorenzini, Patrizia; Loiacono, Laura; Ammassari, Adriana; Bellagamba, Rita; Colafigli, Manuela; D'Ettorre, Gabriella; Di Giambenedetto, Simona; Antinori, Andrea; Zaccarelli, Mauro. - In: BMC INFECTIOUS DISEASES. - ISSN 1471-2334. - 16:1(2016), pp. 1-7. [10.1186/s12879-016-1703-z]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1090635
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