Data from clinical studies confirm the efficacy of switching to Dolutegravir ( DTG ) plus Rilpivirine ( RPV ) ( Juluca ) in selected patients.
The primary objective of the study was to report the 96-week virological suppression, assessing the durability of this strategy in complicated situations.
The secondary objective was to describe the safety and metabolic profile.
All patients who had switched to Dolutegravir plus Rilpivirine between october 1, 2014, and september 30, 2015, were analyzed using a retrospective-prospective design.
Viral control was classified as HIV-1 RNA greater than or equal to 50 copies/mL, 1 to 49 copies/mL, or undetectable ( no virus detected [ NVD ] ).
Researchers have followed 145 patients for a median of 101 weeks. The median age was 52 years; 31.7% were women, and 9.6% non-Caucasian; 50.3% failed at least 1 antiretroviral regimen; and 15% had greater than or equal to 50 copies/mL at baseline.
The reasons for switching were as follows: simplification ( 51.7% ), toxicity ( 36.5% ), drug-drug interactions ( 6.9% ), persistent low-level viremia ( 3.0% ), non-adherence ( 2.1% ), and viral failure ( 1.4% ).
By week 96, seven patients dropped out.
At week 96, none had greater than or equal to 50 HIV-1 RNA copies/mL, 138 ( 95.2% ) had less than 50 copies/mL, and 123 ( 84.8% ) had no virus detected.
The low- to high-density lipoprotein cholesterol ( LDL-C/HDL-C ) ratio decreased significantly ( P = 0.04 ).
Of the 287 baseline altered laboratory parameters, 32.7% normalized by week 96.
Serum glucose and total- and LDL-cholesterol normalization were statistically significant.
In conclusion, switching to Dolutegravir plus Rilpivirine improved viral suppression and LDL-C/HDL-C ratio. ( Xagena )
Capetti AF et al, Ann Pharmacother 2018; 52: 740-746