{"id":36707,"date":"2019-10-18T08:39:44","date_gmt":"2019-10-18T08:39:44","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=36707"},"modified":"2019-10-18T14:59:54","modified_gmt":"2019-10-18T14:59:54","slug":"dolutegravir-plus-rilpivirine-had-good-virologic-safety-record-in-clinics-before-single-tablet-available","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/36707","title":{"rendered":"Dolutegravir plus rilpivirine had good virologic, safety record in clinics before single tablet available"},"content":{"rendered":"

\"\"<\/h2>\n

Mark Mascolini, natap.org<\/span><\/strong><\/p>\n

Before single-table dolutegravir\/rilpivirine (DTG\/RPV) became commercially available, clinicians who combined the two drugs (DTG+RPV) in practice found high rates of virologic control and frequent attainment of treatment goals, according to results of a 10-site US study. [1] <\/span><\/strong><\/p>\n

Only 5 of 66 people stopped DTG+RPV, and only two of them because of virologic failure.<\/span><\/p>\n

In November 2017, DTG\/RPV became the first single-tablet two-drug antiretroviral regimen licensed by the FDA. Intended as maintenance therapy for people already taking a suppressive regimen, DTG\/RPV (Juluca) has now compiled two years of clinic-based experience. But before the single-tablet regimen became available, some clinicians gave DTG+RPV as separate pills for a variety of reasons. This study analysed that US experience.<\/span><\/p>\n

This retrospective chart review involved 278 adults with HIV in care at 1 of 10 US sites and taking any DTG 2-drug regimen. Everyone began the 2-drug regimen before 31 July 2017 and had follow-up data at least to 30 January 2018. This report focused on 66 people (24% of 278) who took DTG+RPV.\u00a0<\/span><\/p>\n

Almost everyone starting DTG+RPV (94%) had antiretroviral experience, logging an average 15.5 years on treatment. Of these 66 people, 79% were men, 68% white, 23% black, and 14% Hispanic. Age averaged 56 years. More than one third of participants (39%) had documented comorbidities, and 26% had mental health issues. Almost half of the study group (49%) had taken four or more prior antiretroviral regimens.\u00a0<\/span><\/p>\n

Clinicians reported that people usually started DTG+RPV to avoid long-term toxicities (53%), to avoid toxicity or intolerance of other antiretrovirals (20%), or to simplify treatment (15%). All but one person took DTG+RPV once daily. The group averaged 1.6 years taking DTG+RPV at the time of this analysis.\u00a0<\/span><\/p>\n

CD4 count before DTG+RPV started averaged 666. Forty-six of 66 people (70%) had a viral load below 50 copies\/mL when starting DTG+RPV, while the rest had a detectable load (averaging about 104,000 copies\/mL). Of the 46 people who began DTG+RPV with an undetectable load, 45 (98%) still had an undetectable load at last follow-up. Among the 20 people with a detectable viral load when starting DTG+RPV, 12 (60%) attained and maintained viral suppression. Two people with an initially detectable load became undetectable then rebounded. Overall, 91% of participants achieved their goal with DTG+RPV, according to their clinician’s report.\u00a0<\/span><\/p>\n

Five of 66 people (8%) stopped DTG+RPV during follow-up, two because of virologic failure, two for further treatment simplification, and 1 because of toxicity\/intolerance.\u00a0<\/span><\/p>\n

“Despite being used in a much more experienced population,\u201d the researchers concluded, \u201creal-world experience with DTG+RPV appears to be consistent with outcomes in phase 3 clinical trials\u201d.<\/span><\/p>\n

Reference<\/span><\/p>\n

    \n
  1. Ward D et al. Real world experience with dolutegravir plus rilpivirine two-drug regimen. IDWeek, October 2-6, 2019, Washington, DC. Abstract 2485.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Mark Mascolini, natap.org Before single-table dolutegravir\/rilpivirine (DTG\/RPV) became commercially available, clinicians who combined the two drugs (DTG+RPV) in practice found high rates of virologic control and frequent attainment of treatment goals, according to results of a 10-site US study. [1] …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3],"tags":[274],"class_list":["post-36707","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","tag-idweek-2019"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/36707","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\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=36707"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/36707\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=36707"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=36707"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=36707"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}