Maraviroc Once-Daily Nucleoside Analog-Sparing Regimen in Treatment-Naive Patients

Autor: Jayvant Heera, Daniel Podzamczer, Anthony Mills, Simon Portsmouth, Donna Mildvan, Manoli Vourvahis, Charles Craig, Hernan Valdez, Manuel Leal, Srinivas Rao Valluri, Alex R. Rinehart, Soe Than, Gerd Fätkenheuer, Lynn McFadyen
Rok vydání: 2013
Předmět:
Zdroj: JAIDS Journal of Acquired Immune Deficiency Syndromes. 62:164-170
ISSN: 1525-4135
DOI: 10.1097/qai.0b013e31827b51b5
Popis: This study was performed to evaluate a once-daily dual-therapy regimen, maraviroc (MVC) + atazanavir/ritonavir (ATV/r), in treatment-naive patients.A phase 2b, randomized, open-label pilot study.In Study A4001078 (NCT00827112), treatment-naive patients with CCR5-tropic HIV-1 (HIV-1 RNA ≥1000 copies/mL; CD4 cell count ≥100 cells/mm) were randomized to receive either MVC 150 mg once daily (n = 60) or tenofovir/emtricitabine (TDF/FTC) 300/200 mg once daily (n = 61) + ATV/r 300/100 mg once daily. Primary endpoint was proportion of patients with HIV-1 RNA50 copies per milliliter at week 48.At week 48, 44 (74.6%) and 51 (83.6%) patients in the MVC and TDF/FTC treatment groups, respectively, had plasma HIV-1 RNA50 copies per milliliter. Median change from baseline in CD4 cell count at week 48 was +173 and +187 cells per cubic millimeter with MVC and TDF/FTC, respectively. Seven patients discontinued from each arm; there were no deaths. The incidence of serious adverse events (AEs) was similar in each group; however, there were more grade 3/4 AEs in the MVC group (18 vs 11), mostly due to hyperbilirubinemia. Three patients in each arm were evaluable for virological analysis at discontinuation or failure (HIV-1 RNA500 copies/mL); no genotypic resistance, change in tropism, or loss of susceptibility relevant to treatment was observed.The virological activity and immunological benefit of once-daily MVC + ATV/r were confirmed. Indirect hyperbilirubinemia and associated signs were the most commonly reported AEs in both study treatment groups and were not associated with significant transaminase increases. No drug resistance occurred.
Databáze: OpenAIRE