Efficacy and safety of nucleoside‐sparing regimen based on raltegravir and ritonavir‐boosted darunavir in HIV‐1‐infected treatment‐experienced patients

Jabłonowska, Elżbieta; Pulik, Piotr; Kalinowska, Agnieszka; Gąsiorowski, Jacek; Parczewski, Miłosz; Bociąga‐Jasik, Monika; Pulik, Łukasz; Siwak, Ewa; Wójcik, Kamila

doi:10.1002/jmv.24826

Cited by 11 publications

(5 citation statements)

References 39 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specific antiviral drugs for a range of viral infections are lacking and systemic supportive therapy and symptomatic treatment remain the mainstays. Nucleoside drugs were the earliest clinically used antivirals, but the side-effects associated with these drugs, including acute renal failure, increase with increasing drug doses [90]. New and effective agents are therefore urgently required.…”

Section: Classical Activities Of Fucoidanmentioning

confidence: 99%

Biological Activities of Fucoidan and the Factors Mediating Its Therapeutic Effects: A Review of Recent Studies

et al. 2019

View full text Add to dashboard Cite

The marine acid polysaccharide fucoidan has attracted attention from both the food and pharmaceutical industries due to its promising therapeutic effects. Fucoidan is a polysaccharide that mainly consists of L-fucose and sulphate groups. Its excellent biological function is attributed to its unique biological structure. Classical activities include antitumor, antioxidant, anticoagulant, antithrombotic, immunoregulatory, antiviral and anti-inflammatory effects. More recently, fucoidan has been shown to alleviate metabolic syndrome, protect the gastrointestinal tract, benefit angiogenesis and bone health. This review focuses on the progress in our understanding of the biological activities of fucoidan, highlighting its benefits for the treatment of human disease. We hope that this review can provide some theoretical basis and inspiration for the product development of fucoidan.

show abstract

Section: Classical Activities Of Fucoidanmentioning

confidence: 99%

Biological Activities of Fucoidan and the Factors Mediating Its Therapeutic Effects: A Review of Recent Studies

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This expressed our expectation that any difference in effectiveness between the two regimens would not be dramatic but within this interval. Second, we reviewed studies where patients switched onto the alternative regimens (boosted darunavir with lamivudine or emtricitabine [23–26], raltegravir with boosted darunavir [27–29]). Based on these studies, we expected a failure rate of approximately 10 failures per 100 patient-years on each control regimen.…”

Section: Methodsmentioning

confidence: 99%

The Comparative Effectiveness of NRTI-Sparing Dual Regimens in Emulated Trials using Observational Data from the Swiss HIV Cohort Study

et al. 2018

View full text Add to dashboard Cite

Background Nucleoside (or nucleotide) reverse transcriptase inhibitors (NRTIs) cause side effects in some patients, prompting the use of either partly or fully NRTI-sparing regimens. Methods We used data from the Swiss HIV Cohort Study to estimate the effectiveness of two new dolutegravir dual regimens relative to the alternative NRTI-sparing dual regimens that our clinicians used previously. We emulated two trials by propensity score matching case patients on the dolutegravir regimen with control patients on an alternative regimen. We analysed the case control sets using a Bayesian Cox model and estimated effectiveness as the percentage still on their trial regimen without virological failure at 48 weeks. Results In a comparison of partly NRTI-sparing regimens, 58 cases treated with dolutegravir were matched to 17 controls treated with boosted darunavir (both with lamivudine or emtricitabine). The estimated difference in effectiveness was 15% (95% credible interval [CrI] 2–33) and 12% (95% CrI 0–26) in two sequential analyses 1 year apart. In a comparison of fully NRTI-sparing regimens, 54 cases treated with dolutegravir were matched to 32 controls treated with raltegravir (both with boosted darunavir). The estimated difference in effectiveness was 9% (95% CrI −1–21) and 5% (95% CrI −4–15) in the two sequential analyses. Conclusions Estimates of relative effectiveness suggest that both dolutegravir regimens are not inferior to these alternative regimens. All four regimens seem suitable for patients needing an NRTI-sparing regimen: there were few virological failures and few treatment changes due to toxicity.

show abstract

“…An observational study evaluating 121 patients treated with RAL combined with PI, reported that approximately 70% of them remained on this regimen with a median treatment duration of 60 months, with treatment simplification being the main reason for 2DR discontinuation in half the 2DR-failing patients [26]. Moreover, only three patients out of 81 (3.7%) who were switched to RAL/DRV/r experienced a virological failure [27]. Indeed, in our cohort, of 54 patients switching to a 2DR combining PI and INSTI, three (5.5%) featured a virological failure, and were switched back to 3DR, while 18 patients were switched to a second line 2DR, mainly due to a need for treatment simplification and 62.9% patients were maintained on PI +INSTI.…”

Section: Plos Onementioning

confidence: 99%

Long term dual antiretroviral therapy: A real life retrospective countrywide Israeli study

et al. 2021

View full text Add to dashboard Cite

Aim Combined antiretroviral treatment (cART) traditionally consists of three antiretroviral medications, while two-drug regimens (2DR), historically used infrequently, recently been suggested to be non-inferior to three-drug regimens, is emerging as a potential treatment option and is currently a recommended option for treatment initiation in many guidelines. Purpose Characterize the indications and clinical efficacy of 2DR use at a real-life setting in a nation-wide survey. Methods A cross-sectional survey of Israeli patients treated by 2DR until July 2019, included demographic, immunologic, virologic, genotypic and biochemical/metabolic parameters at diagnosis, ART initiation, 2DR initiation and following 24, 48, 96 and 144 weeks of 2DR treatment. Results 176 patients were included in the study. In contrast to historical data implicating ART resistance and adverse effects as the major reasons leading to 2DR switching, treatment simplification was the main reason leading to 2DR treatment in 2019. 2DR that included INSTI and PI were more commonly used in cases of drug resistance, while a combination of INSTI and NNRTI was used in all other 2DR indications. A switch to 2DR induced a mean CD4 T cell increase from 599 cells/μl at treatment initiation to 680 cells/μl at 96 weeks of treatment p<0.001 and viral suppression improvement from 73.9% at initiation to 87.0% at 48 weeks of treatment (p = 0.004). PI and INSTI 2DR was inferior in suppressing viral levels compared to other 2DRs but used for subset of more complex patients. Conclusions 2DR in a large-scale real-life nation-wide survey proved to be safe and effective. Most 2DRs, other than PI and INSTI, were similarly effective in suppressing HIV viremia and in elevating CD4 T cell counts.

show abstract

Efficacy and safety of nucleoside‐sparing regimen based on raltegravir and ritonavir‐boosted darunavir in HIV‐1‐infected treatment‐experienced patients

Abstract: Dual therapy was effective and safe for the vast majority of antiretroviral-experienced subjects. Such therapy can be recommended especially for patients with renal impairment or NRTIs intolerance.

Cited by 11 publications

References 39 publications

Biological Activities of Fucoidan and the Factors Mediating Its Therapeutic Effects: A Review of Recent Studies

Biological Activities of Fucoidan and the Factors Mediating Its Therapeutic Effects: A Review of Recent Studies

The Comparative Effectiveness of NRTI-Sparing Dual Regimens in Emulated Trials using Observational Data from the Swiss HIV Cohort Study

Long term dual antiretroviral therapy: A real life retrospective countrywide Israeli study

Contact Info

Product

Resources

About