{"id":2248,"date":"2007-09-03T15:27:48","date_gmt":"2007-09-03T14:27:48","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=2248"},"modified":"2013-09-12T16:45:55","modified_gmt":"2013-09-12T16:45:55","slug":"importance-of-using-maraviroc-in-combination-with-other-active-drugs-in-treatment-experienced-patients","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/2248","title":{"rendered":"Importance of using maraviroc in combination with other active drugs in treatment-experienced patients"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

Two late breaker posters at the meeting presented additional results for maraviroc in treatment-experienced patients.<\/strong><\/p>\n

Elna van der Ryst from Pfizer analysed 24 week efficacy results from the combined Phase III Motivate 1 and 2 studies, by screening genotypic, phenotypic and overall susceptibility scores to OBT, as well as by first-time use of selected background drugs. [1]<\/p>\n

Efficacy results, including response by number of active drugs, were presented at CROI this year, and were reported in the March\/April issue of HTB. [2]<\/p>\n

In these studies, CCR5-tropic patients with triple-class-experience and\/or resistance, and HIV-1-RNA >5000 copies\/mL were randomised 2:2:1 to OBT (3\u00966 ARVs +\/- low-dose ritonavir) plus maraviroc QD, BID or placebo.<\/p>\n

Viral response by use of active lopinavir\/r or T-20 is detailed in Table 1.<\/p>\n

Table 1: Viral response by use of active T-20 or lopinavir\/r<\/strong><\/p>\n\n\n\n\n\n\n
<\/th>\nPBO + OBT: %<50\/<400 copies\/mL<\/th>\nMVC QD + OBT: %<50\/<400 copies\/mL<\/th>\nMVC BID + OBT: %<50\/<400 copies\/mL<\/th>\n<\/tr>\n
Total population<\/td>\n25%\/30% (n=207)<\/td>\n48%\/61% (n=408)<\/td>\n48%\/65% (n=419)<\/td>\n<\/tr>\n
T-20 first use\/no mutations<\/td>\n36%\/40% (n=58)<\/td>\n64%\/75% (n=91)<\/td>\n53%\/75% (n=109)<\/td>\n<\/tr>\n
Lopinavir\/r first use\/no mutations<\/td>\n50%\/60% (n=10)<\/td>\n74%\/96% (n=27)<\/td>\n70%\/87% (n=23)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

In a second poster, Trip Gulick from Weill Medical College of Cornell University, New York, presented efficacy analysis supporting the decision for maraviroc to be dose twice-daily. [3]<\/p>\n

Although tolerability was similar between the two dosing groups, twice-daily dosing provided significantly greater viral suppression, especially for patients with lower baseline CD4, higher baseline viral load, and fewer active drugs in the background regimen (see Table 2).<\/p>\n

Table 2: Virological efficacy of QD vs BID maraviroc<\/strong><\/p>\n\n\n\n\n\n\n\n
<\/th>\nPBO + OBT: %<50\/<400 copies\/mL<\/th>\nMVC QD + OBT: %<50\/<400 copies\/mL<\/th>\nMVC BID + OBT: %<50\/<400 copies\/mL<\/th>\n<\/tr>\n
Overall<\/td>\n23%\/28% (n=209)<\/td>\n44%\/55% (n=414)<\/td>\n45%\/61% (n=426)<\/td>\n<\/tr>\n
No active drugs in OBT (based on genotypic\/phenotypic test results)<\/td>\n3%\/6% (n=35)<\/td>\n18%\/26% (n=51)<\/td>\n29%\/41% (n=56)<\/td>\n<\/tr>\n
Baseline CD4 count <50 cells\/mm3<\/sup><\/td>\n3%\/5% (n=37)<\/td>\n11%\/20% (n=85)<\/td>\n20%\/31% (n=85)<\/td>\n<\/tr>\n
Screening viral load >100,00 copies\/mL<\/td>\n11%\/16% (n=84)<\/td>\n28%\/45% (n=170)<\/td>\n35%\/52% (n=176)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Comment<\/h3>\n

The underperformance in important patient subgroups (low CD4, high viral load, and fewer active drugs in the regimen) clearly supported the choice to develop maraviroc as a twice-daily drug. <\/strong><\/p>\n

References:<\/p>\n

    \n
  1. van der Ryst E, Cooper D, Konourina I et al. Efficacy of maraviroc in combination with at least one other potent new antiretroviral drug: 24-week combined analysis of the MOTIVATE 1 and 2 studies. Abstract WEPEB115LB.
    \nhttp:\/\/www.ias2007.org\/pag\/Abstracts.aspx?AID=5513<\/a><\/li>\n
  2. See: Maraviroc Phase2b\/3 results in treatment-experienced CCR5-tropic patients. HIV Treatment Bulletin, March\/April 2007.
    \nhttp:\/\/www.i-base.info\/htb\/v8\/htb8-3-4\/Maraviroc.html<\/a><\/li>\n
  3. Gulick RM, van der Ryst E, Lampiris H et al. Efficacy and safety of once-daily (QD) compared with twice-daily (BID) maraviroc plus optimised background therapy (OBT) in treatment-experienced patients infected with CCR5-tropic-HIV-1: 24-week combined analysis of the MOTIVATE 1 and 2 studies. Abstract WEPEB115LB.
    \n    http:\/\/www.ias2007.org\/pag\/Abstracts.aspx?AID=5537<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Two late breaker posters at the meeting presented additional results for maraviroc in treatment-experienced patients. Elna van der Ryst from Pfizer analysed 24 week efficacy results from the combined Phase III Motivate 1 and 2 studies, …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3],"tags":[92],"class_list":["post-2248","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","tag-ias-4th-2007"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2248","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=2248"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2248\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=2248"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=2248"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=2248"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}