Monotherapy with boosted PIs as an ART simplification strategy in clinical practice

Autor: Susana Pérez-Álvarez, José Moltó, Isabel Bravo, José R. Santos, Bonaventura Clotet, Roger Paredes, Daniel Berrio-Galan, Cristina Miranda, Núria Pérez-Álvarez, Josep M. Llibre
Přispěvatelé: Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica, Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades
Rok vydání: 2014
Předmět:
Male
reverse-transcriptase inhibitors
HIV Infections
Operations research
Lopinavir
hiv-1-infected patients
immune system diseases
Antiretroviral Therapy
Highly Active
NRTI-sparing regimens
Pharmacology (medical)
nucleoside analogs
Darunavir
Sulfonamides
Matemàtiques i estadística [Àrees temàtiques de la UPC]
virus diseases
Sida -- Tractament
lopinavir-ritonavir monotherapy
Viral Load
Treatment Outcome
Infectious Diseases
Anti-Retroviral Agents
Female
monet trial
Viral load
medicine.drug
Adult
Microbiology (medical)
medicine.medical_specialty
Medicina -- Investigació
Drug-Related Side Effects and Adverse Reactions
Investigació operativa
Pharmacotherapy
Internal medicine
medicine
Humans
darunavir/ritonavir
Adverse effect
Retrospective Studies
Pharmacology
Medicine -- Research
routine clinical setting
Ritonavir
lopinavir/ritonavir monotherapy
business.industry
darunavir/ritonavir monotherapy
Survival Analysis
tenofovir
Surgery
Discontinuation
Regimen
hiv-infected patients
maintenance strategy
HIV-1
business
Zdroj: UPCommons. Portal del coneixement obert de la UPC
Universitat Politècnica de Catalunya (UPC)
RIUVic. Repositorio Institucional de la Universidad de Vic
instname
ISSN: 1460-2091
0305-7453
DOI: 10.1093/jac/dku509
Popis: Background: Data on the efficacy of simplifying therapy using darunavir/ritonavir and lopinavir/ritonavir monotherapy in clinical practice remain limited.; Methods: A retrospective single-centre study including patients initiating darunavir/ritonavir or lopinavir/ritonavir monotherapy with a plasma HIV-1 viral load (pVL) 50 copies/mL or as any change in the regimen after a single determination with a pVL >50 copies/mL) during the follow-up. We also evaluated the percentage of patients remaining free of treatment failure (TF; defined as VF or the early discontinuation of monotherapy for any reason) and compared the effectiveness of the two regimens. Effectiveness was evaluated using cumulative survival analysis (at Weeks 48 and 96). Factors associated with VF and TF were analysed using Cox regression.; Results: A total of 522 patients were included (309 receiving lopinavir/ritonavir and 213 receiving darunavir/ritonavir). The median follow-up was 64.3 (30.5-143.0) weeks. The percentage of patients free of VF and TF was 94% (95% CI 91%-96%) and 79% (95% CI 75%-82%) at 48 weeks, respectively, and 86% (95% CI 81%-89%) and 62% (95% CI 57%-67%) at 96 weeks, respectively. The risk of VF was similar for the two regimens (HR = 1.0, 95% CI 0.6-1.8; P = 0.962). Lopinavir/ritonavir monotherapy was associated with a 1.5-fold greater risk of TF (95% CI 1.1-2.1; P = 0.012) and a 2.3-fold greater risk of discontinuation of therapy due to adverse events (95% CI 1.3-3.9; P = 0.003).; Conclusions: The virological efficacy of darunavir/ritonavir and lopinavir/ritonavir monotherapy is high in clinical practice. Treatment discontinuation due to safety issues is more frequent with lopinavir/ritonavir. This study was supported in part by grants from Lluita contra la SIDA Foundation (Barcelona, Spain), the Spanish AIDS Network ‘Red Temática Cooperativa de Investigación en SIDA’ (RIS, RD06/0006), NEAT (European AIDS Treatment Network), Ministerio de Economía y Competitividad of Spain (MTM2012-38067-C02-01) and GRBIO (Grup de Recerca en Bioestadística i Bioinformàtica; 2014 SGR 464). The funders had no role in study design, data collection and analysis, the decision to publish or drafting of the manuscript.
Databáze: OpenAIRE
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