{"id":553,"date":"2008-08-30T17:02:31","date_gmt":"2008-08-30T16:02:31","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=553"},"modified":"2013-08-27T16:12:11","modified_gmt":"2013-08-27T16:12:11","slug":"boosted-atazanavir-approved-in-europe-as-first-line-therapy","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/553","title":{"rendered":"Boosted atazanavir approved in Europe as first-line therapy"},"content":{"rendered":"

On 24th June 2008, the European Commission granted marketing authorisation for atazanavir boosted by ritonavir (300mg\/100mg once daily), in combination with other antiretrovirals, as a first-line treatment HIV-1 infected adults.<\/strong> [1]<\/p>\n

Previously, atazanavir\/r was only recommended in treatment-experienced patients.<\/p>\n

This decision was based on results from the non-inferiority CASTLE study which randomised almost 900 naive patients to either once-daily atazanavir\/r or twice-daily lopinavir\/r with background tenofovir+FTC. Results were first presented at the Retrovirus conference in February and were reported in the March April issue of HTB. [2]<\/p>\n

Efficacy was similar in both study arms; 78% vs 76% patients in the atazanavir\/r and lopinavir\/r arms respectively achieving viral load <50 copies\/mL at week 48.<\/p>\n

Safety events in the study were consistent with prior experience, and patients taking atazanavir\/r experienced lower rates of Grade 2-4 adverse events such as diarrhoea (2%) and nausea (4%) than those taking lopinavir\/r (11% and 8% respectively). Additionally, the atazanaivr\/r arm was associated with significantly lower increases from baseline compared to the lopinavir\/r arm in total cholesterol, triglycerides and non-HDL cholesterol at 48 weeks (all p<0.0001).<\/p>\n

As with previous observation, 34% of the patients in the atazanaivr\/r arm and less than 1% of patients in the twice-daily lopinavir\/r arm experienced elevations in total bilirubin (hyperbilirubinaemia) greater than 2.5 times the upper limit of normal. This elevation was not associated with liver dysfunction as the rates of Grade 3-4 liver enzyme elevations were similar between treatment groups (2% in once-daily atazanaivr\/r arm vs 1% in the twice-daily lopinavir\/r arm).<\/p>\n

Atazanavir 300mg boosted with 100mg ritonavir is now available in the UK for use in naive patients.<\/p>\n

Comment<\/h3>\n

Many UK clinics were already using atazanavir\/r as first line therapy as a once-daily PI option to efavirenz, and improved tolerability due to only requring 100mg dose of boosting ritonavir.<\/strong><\/p>\n

Atazanavir\/r is now recommended as an alternative to efavirenz in the new BHIVA treatment guidelines (July 2008).<\/strong><\/p>\n

References:<\/p>\n

    \n
  1. Bristol-Myers Squibb press release. “European commission approves boosted Reyataz” 24 June 2008.<\/li>\n
  2. Atazanavir\/r vs lopinavir\/r in treatment-naive patients: 48 week results. HTB March\/April 2008.
    \nhttp:\/\/www.i-base.info\/htb\/v9\/htb9-3-4\/Atazanavir.html<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    On 24th June 2008, the European Commission granted marketing authorisation for atazanavir boosted by ritonavir (300mg\/100mg once daily), in combination with other antiretrovirals, as a first-line treatment HIV-1 infected adults. [1] Previously, atazanavir\/r was only recommended in treatment-experienced patients. This …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-553","post","type-post","status-publish","format-standard","hentry","category-antiretrovirals"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/553","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=553"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/553\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=553"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=553"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}