Brief Report: Improvement in Metabolic Health Parameters at Week 48 After Switching From a Tenofovir Alafenamide–Based 3- or 4-Drug Regimen to the 2-Drug Regimen of Dolutegravir/Lamivudine: The TANGO Study
| Autor: | Stefan Scholten, Jesús Santos, Jean A van Wyk, Mounir Ait-Khaled, Don Smith, Maria-Claudia Nascimento, Allan R Tenorio, Faiza Ajana, Jonathan Wright, Michael Wohlfeiler, Bryn Jones, Brian Wynne |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty Anti-HIV Agents Pyridones 2-drug regimen HIV Infections 030312 virology Weight Gain Gastroenterology Tenofovir alafenamide Piperazines 03 medical and health sciences chemistry.chemical_compound Insulin resistance insulin resistance Antiretroviral Therapy Highly Active Internal medicine Oxazines medicine Humans Pharmacology (medical) Tenofovir Metabolic Syndrome 0303 health sciences Alanine business.industry simplification Lamivudine Odds ratio Clinical Science Viral Load medicine.disease Lipids Confidence interval Infectious Diseases chemistry Dolutegravir ComputingMethodologies_DOCUMENTANDTEXTPROCESSING HIV-1 Drug Therapy Combination Metabolic syndrome medicine.symptom business Heterocyclic Compounds 3-Ring Weight gain medicine.drug |
| Zdroj: | Journal of Acquired Immune Deficiency Syndromes (1999) |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/qai.0000000000002655 |
| Popis: | Supplemental Digital Content is Available in the Text. Background: In TANGO, switching to dolutegravir/lamivudine was noninferior at 48 weeks to continuing 3-/4-drug tenofovir alafenamide–based regimens in virologically suppressed individuals with HIV-1. Antiretroviral agents have been associated with weight gain and metabolic complications. Setting: One hundred thirty-four centers; 10 countries. Methods: We assessed weight; fasting lipids, glucose, and insulin; and prevalence of insulin resistance and metabolic syndrome at baseline and week 48 in TANGO participant subgroups by boosting agent use in baseline regimens (boosted and unboosted). Results: In each treatment group, 74% of participants used boosted regimens at baseline. In boosted and unboosted subgroups, weight and fasting glucose changes at week 48 were small and similar between treatment groups. Overall and in the boosted subgroup, greater decreases from baseline were observed with dolutegravir/lamivudine in fasting total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), triglycerides (P < 0.001), total cholesterol/high-density lipoprotein cholesterol ratio (overall, P = 0.017; boosted, P = 0.007), and insulin (boosted, P = 0.005). Prevalence of HOMA-IR ≥2 was significantly lower at week 48 with dolutegravir/lamivudine overall [adjusted odds ratio (aOR), 0.59; 95% confidence interval (CI), 0.40 to 0.87; P = 0.008] and in the boosted subgroup [aOR, 0.56; 95% CI, 0.36 to 0.88; P = 0.012] but not in the unboosted subgroup [aOR, 0.70; 95% CI, 0.31 to 1.58; P = 0.396]. Prevalence of metabolic syndrome at week 48 was low and consistent between treatment groups overall, with differences trending to favor dolutegravir/lamivudine in the unboosted subgroup [aOR, 0.41; 95% CI, 0.15 to 1.09; P = 0.075]. Conclusion: Generally, switching from 3-/4-drug tenofovir alafenamide–based regimens to dolutegravir/lamivudine improved metabolic parameters, particularly when switching from boosted regimens. Because of smaller sample size in the unboosted subgroup, results warrant further investigation. |
| Databáze: | OpenAIRE |
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