Advertisement

 

 

3-Year efficacy and durability of simplification to single tablet regimens: a comparison between co-formulated efavirenz/emtricitabine/tenofovir and rilpivirine/emtricitabine/tenofovir.

3-Year efficacy and durability of simplification to single tablet regimens: a comparison between co-formulated efavirenz/emtricitabine/tenofovir and rilpivirine/emtricitabine/tenofovir.
Author Information (click to view)

Gagliardini R, Bandera A, Zaccarelli M, Sterrantino G, Latini A, D'Avino A, Lapadula G, Antinori A, Cauda R, De Luca A, Gori A, Di Giambenedetto S, Fabbiani M,


Gagliardini R, Bandera A, Zaccarelli M, Sterrantino G, Latini A, D'Avino A, Lapadula G, Antinori A, Cauda R, De Luca A, Gori A, Di Giambenedetto S, Fabbiani M, (click to view)

Gagliardini R, Bandera A, Zaccarelli M, Sterrantino G, Latini A, D'Avino A, Lapadula G, Antinori A, Cauda R, De Luca A, Gori A, Di Giambenedetto S, Fabbiani M,

Advertisement

Antiviral therapy 2017 08 11() doi 10.3851/IMP3188

Abstract
BACKGROUND
Few data are available about efficacy and durability of simplification from multi-tablet antiretroviral regimens to co-formulated efavirenz(EFV)/emtricitabine(FTC)/tenofovir(TDF) versus rilpivirine(RPV)/emtricitabine/tenofovir in virologically-suppressed HIV-1-infected patients.

METHODS
We retrospectively analyzed HIV-infected patients with HIV-RNA<50copies/mL switching to co-formulated EFV/FTC/TDF or RPV/FTC/TDF at 5 Italian centers. Patients were followed from time of switch until regimen discontinuation or a maximum of 3-years follow-up. Time to treatment discontinuation (TD) and virological failure (VF, defined as two consecutive HIV-RNA>50copies/mL or a single determination >1000copies/mL) and their predictors were investigated.

RESULTS
1560 patients were reviewed of which 1097 (70%) switching to EFV/FTC/TDF and 463 (30%) to RPV/FTC/TDF. During follow-up, VF and TD occurred in 44(4%) and 242(22%) patients in EFV/FTC/TDF and in 29(6%) and 50(11%) patients in RPV/FTC/TDF, respectively. The 3-years estimated probability of remaining free from VF was 96.2% with EFV/FTC/TDF vs 92.7% with RPV/FTC/TDF (p=0.003). At multivariate analysis, regimen type (EFV/FTC/TDF vs RPV/FTC/TDF aHR 0.24, p=0.004) and time of virological suppression (aHR 0.85, p=0.048) were the only independent predictors of VF. The estimated 3-years probability of remaining free from TD was 77.4% with EFV/FTC/TDF vs 88.4% with RPV/FTC/TDF (p=0.001). Predictors of TD were female sex, switching from PI-based regimens, older age, shorter time of virological suppression and regimen type (EFV/FTC/TDF vs RPV/FTC/TDF aHR 2.48, p<0.001). RPV/FTC/TDF showed a safer lipid profile and a greater increase in creatinine. CONCLUSIONS
Both regimens showed good safety and efficacy in this real-life setting, although switch to RPV/FTC/TDF seemed better tolerated while EFV/FTC/TDF was associated with a lower probability of VF.

Submit a Comment

Your email address will not be published. Required fields are marked *

5 + 15 =

[ HIDE/SHOW ]