Question
Should I switch from Evliplera to Delstrigo?
26 March 2022. Related: Access to treatment, Adherence, All topics.
Hello, I have been on Evliplera treatment for about 10 years and doing so well. I have been living in the UK for 5 years and it looks like they are trying to force me to change to Delstrigo as the Eviplera, after brexit for the NHS is too expensive.
I’m a bit scared as I don’t want it to change, plus my first doctor in Italy told me as I had hepatitis B in the past I cannot have it.
I would really appreciate if someone can give me an answer of what I could do .
Many Thanks,
Costa
Answer
Hi, how are you doing?
Both Evliplera and Delstrigo carry the same caution of being used in patients that have liver impairment. They are both to be avoided in those with severe impairment but can be used when the liver is working moderately well or better. As you have been on Evliplera, the caution remains the same if moving onto Delstrigo. Do you have an active hepatitis B infection?
As you have mentioned costings, it is likely for this to be sole reason. The NHS operates on a cost effectiveness basis and unfortunately brexit will have had a hand in this. If you want to stay with Evliplera it is possible you could ask for the medication to be split into 2 pills instead of one as this would be cheaper, however it would require taking 2 pills per day instead of 1.
Evliplera and Delstrigo are both effective and there is no risk to your health of switching. As you have been doing so well already on Evliplera it would be expected to continue this trend on Delstrigo. The benefit of being on Delstrigo is that you would be able to maintain taking only one pill per day.
Have you been given any other reasons for why your doctor is suggesting that you switch?
Josh.
Hi Leila, it is good to hear your positive attitude towards HIV.
Delstrigo is a combination treatment for HIV. More information about it can be found here: https://i-base.info/guides/14410
Delstrigo is for treating what please.as it mentioned its for patients with hiv I have concerns for a relative who is telling me its for heart problem and not being completely honest perhaps scared how ill cope or ashamed its nothing to be ashamed and no one to blame I try to say in many ways I am hear she can tell me anything and
Hi Constantin, I am covering fro Josh while he is away. Good that you are thinking of this change, even though it is strange to leave a combination after so many years. Everyone worries about this, but usually the new treatment turns out to be easy and better.
I have changed ART a few times over the last 20 years. I worried every time, but everytime it was easy and gave be a better quality of life.
The reference to bone changes are linked to the tenofovir (TD) in Delstrigo – and it was also in Atripla. Although there can be a small decline in bone density when first using tenofovir (TD) this is not clinically important for most people. Please talk to your doctor about your concerns as they will have your medical history.
Good evening Josh, I really appreciate your prompt and very lovely response, many thanks for that. I had a chat with my doctor and I’ve decided to give a try with Delstrigo and see how it’s goes.
They are saying it is better than eviplera so let’s see.
As I didn’t change the therapy in 10 years, now I feel a bit scared as I remember in the past between Sustiva and Atripla it’s been a nightmare.
The package leaflet with information on Delstrigo talks about bone problems. Can this be something from Delstrigo?
Many thanks
Constantin