The LOPSAQ study: 48 week analysis of a boosted double protease inhibitor regimen containing lopinavir/ritonavir plus saquinavir without additional antiretroviral therapy

Staszewski, Schlomo; Babacan, Errol; Stephan, Christoph; Haberl, Annette; Carlebach, Amina; Gute, Peter; Klauke, Stephan; Hermschulte, Y.; Stuermer, M.; Dauer, Brenda

doi:10.1093/jac/dkl375

Cited by 40 publications

(41 citation statements)

References 23 publications

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“…(Staszewski, et al, 2006) This approach raises major issues, however, in terms of drug interactions and may be suitable only for patients who have exhausted all other options. This is not strongly advised or recommended and the patient should be referred to an HIV specialist.…”

Section: Double-boosted Pismentioning

confidence: 99%

HIV-1 Treatment-Experienced Patients: Treatment Options and Management

Reid¹,

Novak²

2011

Recent Translational Research in HIV/AIDS

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Section: Double-boosted Pismentioning

confidence: 99%

HIV-1 Treatment-Experienced Patients: Treatment Options and Management

Reid¹,

Novak²

2011

Recent Translational Research in HIV/AIDS

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“…In that study, 42 patients taking one or two PIs were monitored for 105 weeks as part of a larger cohort of patients assessing virological and immunological safety and activity of nucleoside-RTI-sparing regimens. Other studies have assessed preliminary 24-week trials, demonstrating that immune reconstitution and median viral load decreased (Staszewski et al, 2003a, b;Raguin et al, 2004), although these studies were mostly performed on subjects who had a heavy history of treatment before undertaking this regimen. Such experiments were devised only for short time periods and did not assess the long-term impact of PI-only therapy.…”

Section: Article In Pressmentioning

confidence: 99%

Explicitly accounting for antiretroviral drug uptake in theoretical HIV models predicts long-term failure of protease-only therapy

Smith

2008

Journal of Theoretical Biology

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Mathematical models of HIV therapy have traditionally amalgamated the action of antiretroviral drugs, trading the complexity of the situation in favour of simpler-and hence mathematically tractable-models. However, the effects of ignoring such dynamics remain underexamined. In this paper, the traditional method of dosing (where the dose is modelled implicitly as a proportional inhibition of viral infection and production) is compared to a model that accounts for drug dynamics via explicit compartments. Four limiting cases are examined: frequent dosing of both major classes of drugs, absence of either drug, frequent dosing of one drug alone, or frequent dosing of the other drug alone. When drugs are absent, both models predict that the virus will dominate and the uninfected T cell counts will be low. When reverse transcriptase inhibitors are given frequently, both models predict that the virus will be theoretically eliminated and the uninfected T cell counts will be high; this is true regardless of whether the reverse transcriptase inhibitors act alone or in conjunction with protease inhibitors. However, if protease inhibitors alone are given frequently, then the implicit model predicts that the virus will be eliminated and the uninfected T cell counts will be high, whereas the (more realistic) explicit model predicts that the reverse situation may occur. In the latter case, critically, protease-only regimens may ultimately result in the death of the patient. It follows that the impact of drug regimens consisting only of protease inhibitors must be urgently re-examined, if such outcomes have been based on overly simplistic modelling. r

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“…A nucleoside-free combination of lopinavir (LPV)-ritonavir (RTV) and ATV can be an alternative therapy regimen for human immunodeficiency virus type 1 (HIV-1)-infected patients who have no further options with nucleoside reverse transcriptase inhibitors (NRTI) due to toxicity or resistance, as previously shown for other protease inhibitor combinations (12,13,17). Both LPV and ATV are highly potent against HIV-1; i.e., they have a low in vivo 50% inhibitory concentration for wild-type HIV-1 replication (Kaletra package insert, Abbott Laboratories, Chicago, IL; Reyataz Product Information, Bristol Myers-Squibb Company, Princeton, NJ).…”

mentioning

confidence: 99%

Decrease of Atazanavir and Lopinavir Plasma Concentrations in a Boosted Double Human Immunodeficiency Virus Protease Inhibitor Salvage Regimen

Hentig

Kaykhin²,

Stephan³

et al. 2008

Antimicrob Agents Chemother

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The human immunodeficiency virus protease inhibitor combination of atazanavir (ATV)-lopinavir-ritonavir was reported to exhibit a mutual pharmacoenhancement of plasma lopinavir and ATV concentrations which may be beneficial for salvage patients. We identified 17 patients in our pharmacokinetic database taking this combination and found conflicting results. Plasma concentrations of both ATV and lopinavir were modestly, although not significantly, decreased when the drugs were coadministered. Therefore, patients should be selected carefully for this regimen and frequent clinical and therapeutic drug monitoring is strongly advised.

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The LOPSAQ study: 48 week analysis of a boosted double protease inhibitor regimen containing lopinavir/ritonavir plus saquinavir without additional antiretroviral therapy

Cited by 40 publications

References 23 publications

HIV-1 Treatment-Experienced Patients: Treatment Options and Management

HIV-1 Treatment-Experienced Patients: Treatment Options and Management

Explicitly accounting for antiretroviral drug uptake in theoretical HIV models predicts long-term failure of protease-only therapy

Decrease of Atazanavir and Lopinavir Plasma Concentrations in a Boosted Double Human Immunodeficiency Virus Protease Inhibitor Salvage Regimen

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