{"id":7361,"date":"2005-05-15T18:44:48","date_gmt":"2005-05-15T17:44:48","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7361"},"modified":"2014-05-21T18:09:19","modified_gmt":"2014-05-21T18:09:19","slug":"once-daily-lopinavirritonavir-for-children-may-offer-advantages","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7361","title":{"rendered":"Once-daily lopinavir\/ritonavir for children may offer advantages"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

A once-daily dosing schedule for HIV-positive children may offer an advantage to families and healthcare workers in terms of convenience and adherence. The currently approved paediatric dose of lopinavir\/ritonavir (LPV\/r, Kaletra) is 230\/57.5 mg\/m2 taken twice daily with food. Gwenda Verweel and colleagues evaluated the pharmacokinetics, tolerability, and efficacy of once-daily dosing of LPV\/r in children.<\/strong><\/p>\n

In this study children on stable treatment with a viral load < 50 copies\/mL for at least 6 months received LPV\/r 460\/115 mg\/m2 once daily with AZT and 3TC. LPV\/r was taken with food in the morning. Intensive pharmacokinetic studies were performed after observed drug intake during steady state at two weeks. Target for Cmin was 1.0mg\/L. After this period the time of dosing could be changed to the evening meal.<\/p>\n

Single sample plasma levels were collected at day 28 and months 2, 3, and 6. Clinical assessment included plasma RNA levels, lymphocyte counts, biochemistry, haematology, and side effects monitoring.<\/p>\n

Six-month follow up results were available for 14 children (7 boys and 7 girls) with a median age of 4.5 (range 3.3 to 9.5) years. The dose of LPV\/r 460\/115 mg\/m2 once daily, resulted in comparable LPV plasma levels to those in adults after an 800\/200 mg once-daily regimen.<\/p>\n

The authors report that: 3\/14 children had a C trough that was considered to be too low (< 1.0 mg\/L) and a dose increase was necessary; 11 children took LPV\/r with their evening meal; and 44% (17 of 39) of the LPV\/r plasma levels were higher than their corresponding values on day 14. 2\/3 children taking LPV\/r with breakfast had lower plasma levels than those on day 14.<\/p>\n

All 14 children had viral load < 50 copies\/mL after 6 months of treatment. CD4 cell counts did not change significantly during the study.<\/p>\n

This once-daily regimen of LPV\/r was generally well tolerated. Of the 14 children, 6 experienced mild gastrointestinal side effects but all were resolved after 2 months. Cholesterol and triglyceride levels were stable during 6 months of follow-up.<\/p>\n

The authors concluded that LPV\/r 460\/115 mg\/m2 once daily led to LPV plasma levels comparable to adult data. In 3 of 14 children dose increase to 600mg\/m2 or 798mg\/m2 was necessary because of low Cmin (24hr). Intake with a large meal (like dinner) is important to obtain adequate plasma levels when LPV\/r is dosed once daily in children. They also noted that because of interpatient variability in plasma levels, TDM might be useful to guide the correct dose for children.<\/p>\n","protected":false},"excerpt":{"rendered":"

Polly Clayden, HIV i-Base A once-daily dosing schedule for HIV-positive children may offer an advantage to families and healthcare workers in terms of convenience and adherence. The currently approved paediatric dose of lopinavir\/ritonavir (LPV\/r, Kaletra) is 230\/57.5 mg\/m2 taken twice …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,32],"tags":[59],"class_list":["post-7361","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-paediatric-care","tag-croi-2005"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7361","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=7361"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7361\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7361"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7361"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}