Weight gain after antiretroviral therapy initiation in people living with HIV in the United States: analyses of electronic medical records and prescription claims.
| Autor: | Zhao X; Real World Solutions, IQVIA, Durham, NC, USA., Prajapati G; Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA., Tse J; Real World Solutions, IQVIA, Durham, NC, USA., Near AM; Real World Solutions, IQVIA, Durham, NC, USA., Kumar PN; Department of Medicine and Microbiology, Georgetown University Medical Center, Washington, DC, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Current medical research and opinion [Curr Med Res Opin] 2023 Jul; Vol. 39 (7), pp. 997-1006. Date of Electronic Publication: 2023 Jun 24. |
| DOI: | 10.1080/03007995.2023.2224165 |
| Abstrakt: | Background: Treatment guidelines recommend integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) regimens for treatment naïve people living with HIV (PLWH) in the United States (US). This retrospective database study compared weight changes following initiation of INSTI-, non-nucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based ART in treatment-naïve PLWH. Methods: Adult (≥18 years) PLWH initiated on INSTI, NNRTI, or PI plus ≥2 nucleoside reverse transcriptase inhibitors (NRTI) between 1 January 2014 to 31 August 2019 were identified in IQVIA's Ambulatory Electronic Medical Records (AEMR) linked to prescription drug claims (LRx). Weight changes over up to 36 months (M) of follow-up were compared among PLWH on INSTI- vs. NNRTI- and PI-based ART separately using non-linear mixed effect models, adjusting for demographics and baseline clinical characteristics. Results: The INSTI, NNRTI, and PI cohorts included 931, 245, and 124 PLWH, respectively. For all three cohorts, the majority were male (78.2-81.2%) and overweight/obese (53.6-61.6%) at baseline; 40.8-45.2% of the groups were African American. The INSTI vs. NNRTI/PI cohorts were younger (median age: 38 years vs. 44 years/46 years), had lower weight at ART initiation (mean: 80.9 kg vs. 85.7 kg/85.0 kg), and had higher TAF usage during follow-up (55.6% vs. 24.1%/25.8%; all p < .05). Multivariate models showed higher weight gain among PLWH in INSTI vs. NNRTI and PI cohorts during treated follow-up (estimated weight gain after 36 M: 7.1 kg vs. 3.8 kg and 3.8 kg, both p < .05). Conclusion: Study findings highlight the need to monitor an increase in weight and potential metabolic complications among PLWH starting ART with INSTI. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|