Real life use of dolutegravir doravirine dual regimen in experienced elderly PLWH with multiple comorbidities and on polypharmacy: A retrospective analysis.
Aged
Aged, 80 and over
Anti-HIV Agents
/ therapeutic use
Female
HIV Infections
/ drug therapy
Heterocyclic Compounds, 3-Ring
/ therapeutic use
Humans
Infant
Male
Middle Aged
Oxazines
/ therapeutic use
Piperazines
/ therapeutic use
Polypharmacy
Pyridones
/ therapeutic use
Retrospective Studies
Treatment Outcome
Triazoles
/ therapeutic use
Viral Load
/ drug effects
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
30 Dec 2021
30 Dec 2021
Historique:
received:
20
10
2021
accepted:
16
12
2021
entrez:
30
12
2021
pubmed:
31
12
2021
medline:
19
2
2022
Statut:
ppublish
Résumé
By increasing life expectancy of people living with HIV, the most clinical challenge is managing both drug-to-drug interactions and comorbidities (especially metabolic). Doravirine (DOR), a new non-nucleoside reverse transcriptase inhibitor, recently approved for the treatment of HIV, could be a good companion of dolutegravir (DTG) in a dual regimen for experienced elderly patients with multimorbidity and polypharmacy.We herein report our preliminary experience in a small cohort of elderly patients (>50 years of age) with multimorbidity and on polypharmacy who were switched to DOR/DTG dual regimen and followed-up for 3 months. The study was conducted at the Infectious and Tropical Diseases Unit of Padua University Hospital, Italy.Eighteen patients were included, 72.2% males and 27.8% postmenopausal women, mean age was of 61.3 years (7.6), 50% experienced AIDS events. Switches to DOR and DTG were mainly due to high cardiovascular and metabolic risk (72.2%), and interactions among comedications (50%). Antiretrovirals that subjects were switched off were mostly boosted protease inhibitors 66.7%. We observed a viral suppression among all subjects. Interestingly, we observed a statistically significant reduction in body mass index, body weight and waist circumference, eGFR, and a significant increase in serum creatinine levels. No significant changes in CD4+ T cell count was observed from the baseline. Lipid and fasting glucose values did not change significantly.To the best of our knowledge this is the first experience reporting real-life outcome of switch to DTG + DOR in elderly with multimorbidity and on polypharmacy. From our very preliminary data the dual combination of DTG and DOR could be a good treatment strategy for these subjects. However, our findings need to be validated on a greater number of patients.
Identifiants
pubmed: 34967394
doi: 10.1097/MD.0000000000028488
pii: 00005792-202112300-00049
pmc: PMC8718210
doi:
Substances chimiques
Anti-HIV Agents
0
Heterocyclic Compounds, 3-Ring
0
Oxazines
0
Piperazines
0
Pyridones
0
Triazoles
0
doravirine
913P6LK81M
dolutegravir
DKO1W9H7M1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28488Subventions
Organisme : none
ID : none
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
Références
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