Efficacy and safety of dolutegravir and rilpivirine dual therapy as a simplification strategy: a cohort study

Gantner, Pierre; Cuzin, Lise; Allavena, Clotilde; Cabie, André; Puglièse, Pascal; Valantin, M.A.; Bani‐Sadr, Firouzé; Joly, Véronique; Ferry, Tristan; Poizot‐Martin, Isabelle; Garraffo, R.; Peytavin, Gilles; Fafi‐Kremer, Samira; Rey, David

doi:10.1111/hiv.12506

Cited by 45 publications

(31 citation statements)

References 20 publications

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“…Recent data of the ANRS163-ETRAL study showed the robust and potent activity with an excellent safety profile of the dual therapy raltegravir plus etravirine in subjects over 45 years virologically suppressed and with a long history of antiretroviral therapy and frequent lipodystrophy[ 21 ]. The dual therapy in maintenance of dolutegravir plus either rilpivirine or lamivudine have also shown reassuring results both on efficacy and renal tolerability, with the advantage of a simple once-daily regimen[ 22 ] [ 18 ]. With the development of these new promising PI-sparing and/or NRTI-sparing switch dual therapy, future studies need to address their specific benefit in HIV geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

Allavena¹,

Hanf²,

Rey³

et al. 2018

PLoS ONE

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As HIV-infected adults on successful antiretroviral therapy (ART) are expected to have close to normal lifespans, they will increasingly develop age-related comorbidities. The objective of this cross-sectional study was to compare in the French Dat’AIDS cohort, the HIV geriatric population, aged 75 years and over, to the elderly one, aged from 50 to 74 years. As of Dec 2015, 16,436 subjects (43.8% of the French Dat’AIDS cohort) were aged from 50 to 74 (elderly group) and 572 subjects (1.5%) were aged 75 and over (geriatric group). Durations of HIV infection and of ART were slightly but significantly different, median at 19 and 18 years, and 15 and 16 years in the elderly and geriatric group, respectively. The geriatric group was more frequently at CDC stage C and had a lower nadir CD4. This group had been more exposed to first generation protease inhibitors and thymidine analogues. Despite similar virologic suppression, type of ART at the last visit significantly differed between the 2 groups: triple ART in 74% versus 68.2%, ART ≥ 4 drugs in 4.7% versus 2.7%; dual therapy in 11.6% versus 16.4% in the elderly group and the geriatric group, respectively. In the geriatric group all co-morbidities were significantly more frequent, except dyslipidemia, 4.3% of the elderly group had ≥4 co-morbidities versus18.4% in the geriatric group. Despite more co-morbidities and more advanced HIV infection the geriatric population achieve similar high rate of virologic suppression than the elderly population. A multidisciplinary approach should be developed to face the incoming challenge of aging HIV population.

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Section: Discussionmentioning

confidence: 99%

Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

Allavena¹,

Hanf²,

Rey³

et al. 2018

PLoS ONE

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“…Long-term extension data have shown 2DR durability with minimal development of resistance [37]. Two observational studies of DTG/ RPV used in treatment-experienced patients have also demonstrated good efficacy among a real-world population [51,52].…”

Section: Discussionmentioning

confidence: 99%

Two’s a Company, Three’s a Crowd: A Review of Initiating or Switching to a Two-Drug Antiretroviral Regimen in Treatment-Naïve and Treatment-Experienced Patients Living with HIV-1

Badowski¹,

Pérez²,

Schwartz³

et al. 2020

Infect Dis Ther

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Introduction: As HIV has become a manageable chronic condition, a renewed and increased interest in challenging traditional three-drug HIV therapies and moving toward two-drug regimens (2DR) for initial or maintenance treatment in people living with HIV (PLWH) has developed. As PLWH are living longer, continual advancements in antiretroviral regimens have been a focus to provide optimal lifelong therapy options. Although early studies may have shown poor outcomes in virologic suppression with 2DR, newer studies and treatment options have emerged to show promise in the management of HIV. The purpose of this review is to evaluate current literature and assess the efficacy of two-drug (2DR) antiretroviral therapy in treatment-naïve and -experienced people living with HIV.

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“…Physicians must still consider the problems that could arise from the continued use of an NRTI (3TC). In previous DTG/RPV studies, effective viral suppression was observed in patients who switched owing to treatment failure [ 13 14 15 16 ]. The outcome was favorable in the DTG/RPV study.…”

Section: Discussionmentioning

confidence: 99%

“…Dual regimen combinations have been considered as maintenance therapy for simplification [ 7 8 9 10 11 12 13 14 15 16 17 18 ]. Dual therapy with a favorable outcome has been reported in treatment-experienced patients without previous virological failure; LAMIDOL study (a trial evaluating maintenance therapy with lamivudine and DTG in HIV-1 infected patients virologically suppressed with triple HAART), SWORD study (regimen switch to DTG plus rilpivirine from current antiretroviral regimen in HIV-1 infected and virologically suppressed adults) and DUALIS study (dual therapy with boosted DRV plus DTG) [ 7 8 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness, Safety, and Tolerability of a Switch to Dual Therapy with Dolutegravir Plus Cobicistat-Boosted Darunavir in Treatment-Experienced Patients with Human Immunodeficiency Virus

et al. 2018

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BackgroundDual regimen with dolutegravir plus cobicistat-boosted darunavir (DTG/DRV/c) is reasonable alternative option for patients with existing resistance and/or intolerance to nucleoside reverse transcriptase inhibitors (NRTIs).Material and MethodsAll patients who switched to DTG/DRV/c among treatment-experienced patients with human immunodeficiency virus (HIV) in a tertiary university hospital were selected. We analyzed the effectiveness, safety, and tolerability based on serial laboratory data and clinical findings. The primary endpoint was defined as the proportion of patients with plasma HIV RNA below 50 copies/mL at week 48 after switch. Secondary endpoints included evaluation of safety and tolerability.ResultsThirty-one patients were retrospectively analyzed. The main reasons for the change to DTG/DRV/c were treatment failure in 13 patients (41.9%), simplification in 12 patients (38.7%), and adverse drug reaction in 6 patients (19.4%). Among the 13 patients who switched owing to treatment failure, the proportion of patients in whom the viral loads were suppressed to less than 50 copies/mL increased from 0% at baseline to 45% at 4 weeks, 50% at 12 weeks, 50% at 24 weeks, and 66.7% at 48 weeks. HIV virus levels decreased and CD4+ T cell counts increased during the follow-up period. In non-treatment failure patients (18 patients), the levels of viral suppression and CD4+ T cells were maintained. There were no significant differences in renal function, liver function, glucose levels, and lipid profile before and after regimen changes. The tolerability was very good: 30 patients (96.8%) tolerated the drugs well and only 1 patient discontinued owing to no improvement in renal insufficiency. Two patients (6.4%) in treatment failure group failed to reach viral suppression.ConclusionThe use of DTG/DRV/c in HIV treatment-experienced patients appears to be a very good regimen for switch therapy that is effective and well tolerated, without significant adverse drug reaction.

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Efficacy and safety of dolutegravir and rilpivirine dual therapy as a simplification strategy: a cohort study

Cited by 45 publications

References 20 publications

Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

Two’s a Company, Three’s a Crowd: A Review of Initiating or Switching to a Two-Drug Antiretroviral Regimen in Treatment-Naïve and Treatment-Experienced Patients Living with HIV-1

Effectiveness, Safety, and Tolerability of a Switch to Dual Therapy with Dolutegravir Plus Cobicistat-Boosted Darunavir in Treatment-Experienced Patients with Human Immunodeficiency Virus

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