Regimen Simplification to Atazanavir-Ritonavir Alone as Maintenance Antiretroviral Therapy After Sustained Virologic Suppression

Swindells, Susan; DiRienzo, A. Gregory; Wilkin, Timothy; Fletcher, Courtney V.; Margolis, David M.; Thal, Gary; Godfrey, Catherine; Bastow, Barbara; Ray, Michelle; Wang, Hongying; Coombs, Robert W.; McKinnon, John; Mellors, John W.

doi:10.1001/jama.296.7.806

Cited by 77 publications

(56 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ATV is one of the leading protease inhibitors currently prescribed in the clinic. 31,32 Daily doses of RTV, another protease inhibitor, are used to boost ATV levels, thus a sustained-release formulation containing both ATV and RTV would help simplify ART regimens. 32 Our NP manufactured with RTV showed that MDM retained the drug for up to 10 days.…”

Section: Discussionmentioning

confidence: 99%

“…This observation is significant as ATV is a leading drug in the clinic. 31,32 While initial medium levels (24 hour post-treatment) were variable between wet milled or homogenized and PLGA formulations, the rate of decline was similar for wet milled and homogenized formulations. Medium levels at day 1 were higher for H1004 than for M1004, but the rates of decline were similar for both formulations.…”

mentioning

confidence: 96%

See 1 more Smart Citation

Comparative manufacture and cell-based delivery of antiretroviral nanoformulations

Balkundi¹,

Nowacek²,

Veerubhotla³

et al. 2011

IJN

View full text Add to dashboard Cite

Nanoformulations of crystalline indinavir, ritonavir, atazanavir, and efavirenz were manufactured by wet milling, homogenization or sonication with a variety of excipients. The chemical, biological, immune, virological, and toxicological properties of these formulations were compared using an established monocyte-derived macrophage scoring indicator system. Measurements of drug uptake, retention, release, and antiretroviral activity demonstrated differences amongst preparation methods. Interestingly, for drug cell targeting and antiretroviral responses the most significant difference among the particles was the drug itself. We posit that the choice of drug and formulation composition may ultimately affect clinical utility.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 96%

Comparative manufacture and cell-based delivery of antiretroviral nanoformulations

Balkundi¹,

Nowacek²,

Veerubhotla³

et al. 2011

IJN

View full text Add to dashboard Cite

show abstract

“…10,11,[13][14][15] The barrier to resistance of bPIs is also high compared with nucleoside and non-nucleoside analogues. Additionally, the non-overlapping resistance profile with other available ARV drug classes would mean that existing standard triple-drug regimens for symptomatic patients would be unaffected as both nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) would be preserved.…”

Section: Ways Forwardmentioning

confidence: 99%

Antiretroviral therapy for HIV prevention: many concerns and challenges, but are there ways forward in sub-Saharan Africa?

Zachariah

Harries

Philips

et al. 2010

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

“…78 All participants switched to ATV/r at entry and discontinued the NRTI backbone after 6 weeks. Three participants (9%) experienced virologic failure at weeks 12, 14 and 20 after simplifi cation, with plasma HIV-RNA levels of 4730, 1285 and 28397 copies/mL, respectively.…”

Section: Atazanavir/ritonavir Monotherapymentioning

confidence: 99%

Role of atazanavir in the treatment of HIV infection

Soriano¹

2008

TCRM

View full text Add to dashboard Cite

Atazanavir (ATV) is one of the latest protease inhibitors (PI) approved for the treatment of HIV infection. The drug has a relatively long-life (∼7 h) and large inhibitory quotient which allows once daily administration. It is generally well tolerated and the main side effect is hyperbilirubinemia, since ATV inhibits the hepatic uridin-glucoronyl-transferase. A signature mutation at the protease gene, I50L, may confer loss of susceptibility to the drug. Interestingly, it produces hypersusceptibility to all other PIs. When ATV is pharmacokinetically boosted with ritonavir (r) 100 mg/day, a greater genetic barrier for resistance is achieved, and generally more than 3 major PI resistance associated mutations are needed to result in ATV resistance. In drugnaïve subjects, regimens based on ATV/r have shown non-inferiority compared to lopinavir (LPV)/r (CASTLE study) or fosamprenavir/r (ALERT trial), generally with improved tolerance (less diarrhea and dyslipidemia). Given its good tolerance and convenience, ATV has been proven to be successful as a simplifi cation strategy in switch studies (ie, SWAN and SLOAT) conducted in patients with complete virological suppression under other PI-based regimens. Finally, ATV/r-based combinations have shown to be equivalent in terms of viral response to other PI/r-containing regimens, including LPV/r, in rescue interventions in patients failing other PI regimens (ie, studies AI424-045 and NADIS).

show abstract

Regimen Simplification to Atazanavir-Ritonavir Alone as Maintenance Antiretroviral Therapy After Sustained Virologic Suppression

Cited by 77 publications

References 15 publications

Comparative manufacture and cell-based delivery of antiretroviral nanoformulations

Comparative manufacture and cell-based delivery of antiretroviral nanoformulations

Antiretroviral therapy for HIV prevention: many concerns and challenges, but are there ways forward in sub-Saharan Africa?

Role of atazanavir in the treatment of HIV infection

Contact Info

Product

Resources

About