Comparing the efficacy and safety of a first line regimen with emtricitabine/tenofovir alafenamide fumarate plus either bictegravir or dolutegravir: Results from clinical practice.
Bictegravir
HIV
dolutegravir
first-line
naive
Journal
International journal of antimicrobial agents
ISSN: 1872-7913
Titre abrégé: Int J Antimicrob Agents
Pays: Netherlands
ID NLM: 9111860
Informations de publication
Date de publication:
17 Nov 2023
17 Nov 2023
Historique:
received:
13
02
2023
revised:
29
10
2023
accepted:
14
11
2023
medline:
20
11
2023
pubmed:
20
11
2023
entrez:
19
11
2023
Statut:
aheadofprint
Résumé
In the last decade, first-line Integrase strand transfer inhibitors (INSTI) based regimens have become commonly used in clinical practice. We aimed to analyze and compare the efficacy and safety of bictegravir (BIC) and dolutegravir (DTG) when prescribed in association with emtricitabine/tenofovir alafenamide (FTC/TAF) as part of a first-line regimen for the treatment of HIV-1 infection. We analyzed a cohort of treatment naïve PLWHIV starting a first line regimen with either BIC/FTC/TAF (BIC group) or FTC/TAF+DTG (DTG group). We performed snapshot analyses after 24 and 48 weeks evaluating virological efficacy. We also evaluated differences in the rate of treatment discontinuation (TD) between the two groups, via the Kaplan Meier method and the Log Rank test. We analyzed data from 327 PLWHIV: 140 in the DTG group and 187 in the BIC group. At 48 weeks, 90.0% of individuals in the DTG group and 86.7% of those in the BIC group achieved a HIV-RNA<50 copies/mL. We observed 88 TD in the DTG group and 38 in the BIC group; estimated probabilities of maintaining study regimen at week 48 were 59.5% in the DTG group and 84.2% in the BIC group. Analyzing changes in immunological parameters after 48 weeks, we registered a median improvement of +169 cell/mm3 (p<0.001) in the DTG group and +233 cell/mm3 (p<0.001) in the BIC group. Both BIC and DTG, in combination with FTC/TAF, show promising efficacy and safety as first-line strategies in clinical practice, with a favorable immunological recovery even in the short term.
Sections du résumé
BACKGROUND
BACKGROUND
In the last decade, first-line Integrase strand transfer inhibitors (INSTI) based regimens have become commonly used in clinical practice. We aimed to analyze and compare the efficacy and safety of bictegravir (BIC) and dolutegravir (DTG) when prescribed in association with emtricitabine/tenofovir alafenamide (FTC/TAF) as part of a first-line regimen for the treatment of HIV-1 infection.
METHODS
METHODS
We analyzed a cohort of treatment naïve PLWHIV starting a first line regimen with either BIC/FTC/TAF (BIC group) or FTC/TAF+DTG (DTG group). We performed snapshot analyses after 24 and 48 weeks evaluating virological efficacy. We also evaluated differences in the rate of treatment discontinuation (TD) between the two groups, via the Kaplan Meier method and the Log Rank test.
RESULTS
RESULTS
We analyzed data from 327 PLWHIV: 140 in the DTG group and 187 in the BIC group. At 48 weeks, 90.0% of individuals in the DTG group and 86.7% of those in the BIC group achieved a HIV-RNA<50 copies/mL. We observed 88 TD in the DTG group and 38 in the BIC group; estimated probabilities of maintaining study regimen at week 48 were 59.5% in the DTG group and 84.2% in the BIC group. Analyzing changes in immunological parameters after 48 weeks, we registered a median improvement of +169 cell/mm3 (p<0.001) in the DTG group and +233 cell/mm3 (p<0.001) in the BIC group.
CONCLUSIONS
CONCLUSIONS
Both BIC and DTG, in combination with FTC/TAF, show promising efficacy and safety as first-line strategies in clinical practice, with a favorable immunological recovery even in the short term.
Identifiants
pubmed: 37981074
pii: S0924-8579(23)00329-1
doi: 10.1016/j.ijantimicag.2023.107040
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107040Informations de copyright
Copyright © 2023. Published by Elsevier Ltd.