HIV Treatment with the Two-Drug Regimen Dolutegravir Plus Lamivudine in Real-world Clinical Practice: A Systematic Literature Review.

Autor: Patel R; ViiV Healthcare, 980 Great West Road, Brentford, TW8 9GS, Middlesex, UK. rickesh.x.patel@viivhealthcare.com., Evitt L; ViiV Healthcare, 980 Great West Road, Brentford, TW8 9GS, Middlesex, UK., Mariolis I; ViiV Healthcare, Athens, Greece., Di Giambenedetto S; UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy., d'Arminio Monforte A; Department of Health Sciences, Clinic of Infectious Diseases, 'San Paolo' Hospital, University of Milan, Milan, Italy., Casado J; Hospital Universitario Ramón y Cajal, Madrid, Spain., Cabello Úbeda A; Infectious Diseases Division, Fundación Jimenez Diaz University Hospital, Madrid, Spain., Hocqueloux L; Infectious Diseases Department, Centre Hospitalier Régional d'Orléans, Orléans, France., Allavena C; Infectious Diseases Department, CHU Hôtel-Dieu, Nantes, France., Barber T; Royal Free London NHS Foundation Trust, London, UK., Jha D; GlaxoSmithKline Knowledge Centre, Gurgaon, Haryana, India., Kumar R; GlaxoSmithKline Knowledge Centre, Gurgaon, Haryana, India., Kamath RD; GlaxoSmithKline Knowledge Centre, Gurgaon, Haryana, India., Vincent T; ViiV Healthcare, 980 Great West Road, Brentford, TW8 9GS, Middlesex, UK., van Wyk J; ViiV Healthcare, 980 Great West Road, Brentford, TW8 9GS, Middlesex, UK., Koteff J; ViiV Healthcare, Research Triangle Park, NC, USA.
Jazyk: angličtina
Zdroj: Infectious diseases and therapy [Infect Dis Ther] 2021 Dec; Vol. 10 (4), pp. 2051-2070. Date of Electronic Publication: 2021 Aug 24.
DOI: 10.1007/s40121-021-00522-7
Abstrakt: The two-drug regimen dolutegravir plus lamivudine demonstrated durable efficacy for up to 3 years in phase III studies and a high barrier to resistance in treatment-naive and virologically suppressed people with HIV (PWH). This systematic literature review summarizes real-world evidence evaluating effectiveness and safety of dolutegravir plus lamivudine. We searched Ovid MEDLINE ® , Embase ® , PubMed, Cochrane library, and relevant international conference proceedings from 2013 to 2020. Qualitative synthesis of virologic suppression at Week 48, treatment-emergent resistance, discontinuation rates, and comorbidities was undertaken, with no statistical analyses conducted. Linked publications and potential for duplication in reporting of outcomes for cohorts and populations were identified, and the publication reporting the highest number of PWH receiving dolutegravir plus lamivudine was included in the analysis. Thirty-four studies reporting on cohorts of PWH not suspected to be linked or to include duplicate data receiving dolutegravir plus lamivudine were identified (N = 5017). Of 3744 virologically suppressed PWH who switched to dolutegravir plus lamivudine, 603 (16%) reported history of virologic failure. Nineteen studies included effectiveness data (n = 3558), four of which included data from treatment-naive PWH (n = 69). In studies with > 100 PWH, high rates of virologic suppression (Week 48, 97-100%) were maintained with dolutegravir plus lamivudine, with low rates of virologic failure (0-3.3 per 100 person-years of follow-up); one instance of emergent integrase strand transfer inhibitor resistance was reported in a complex treatment-experienced individual. Rates of discontinuation due to adverse events were low and consistent with previously observed trial data. Dolutegravir plus lamivudine minimally impacted renal function and had minimal impact on or improved lipid profiles and bone mineral density. This systematic review demonstrates that effectiveness and safety of dolutegravir plus lamivudine in clinical practice support data from randomized controlled trials with regard to high rates of virologic response, low rates of discontinuation, and a high barrier to resistance.
(© 2021. The Author(s).)
Databáze: MEDLINE
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