Doravirine: its role in HIV treatment.

IF 4.5 3区 医学 Q2 IMMUNOLOGY Current Opinion in HIV and AIDS Pub Date : 2022-01-01 DOI:10.1097/COH.0000000000000709
Alexander J Stockdale, Saye Khoo
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引用次数: 7

Abstract

Purpose of review: We reviewed evidence concerning the novel nonnucleoside reverse transcriptase inhibitor doravirine, aiming to identify situations where it may be selected in preference to integrase inhibitors.

Recent findings: Doravirine is licenced for the treatment of HIV-1 in North America and Europe. In two multicentre randomized controlled trials, noninferiority with comparator drugs efavirenz and darunavir/ritonavir was observed at 96 weeks. Doravirine is associated with a lower incidence of neuropsychiatric side effects relative to efavirenz, and favourable lipid changes relative to darunavir over 96 weeks. A lower incidence of weight gain, relative to indirect comparisons with integrase inhibitors, was observed. Doravirine has a high genetic barrier to resistance with retained activity in the presence of single NNRTI mutations K103N, Y181C and G190A. Primary drug resistance is infrequent and may be higher in South Africa relative to European populations. Doravirine may be used in renal or hepatic impairment and has a low potential for drug-drug interactions.

Summary: Doravirine is a well tolerated and effective agent in ART-naive patients. Direct comparison with integrase inhibitors, and evidence on the outcomes of treatment with doravirine in the presence of prior NNRTI experience are required to better elucidate which patients will benefit most from doravirine therapy.

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多拉韦林:它在艾滋病治疗中的作用。
综述的目的:我们回顾了有关新型非核苷类逆转录酶抑制剂doravirine的证据,旨在确定在哪些情况下可以优先选择doravirine而不是整合酶抑制剂。最近的发现:Doravirine在北美和欧洲被批准用于治疗HIV-1。在两项多中心随机对照试验中,在96周时观察到比较药依非韦伦和达那韦/利托那韦的非劣效性。与依非韦伦相比,多拉韦林的神经精神副作用发生率较低,在96周内,与达鲁那韦相比,多拉韦林的血脂变化有利。相对于整合酶抑制剂的间接比较,观察到体重增加的发生率较低。Doravirine在存在单一NNRTI突变K103N、Y181C和G190A的情况下,对耐药具有很高的遗传屏障,并保持活性。原发性耐药性并不常见,与欧洲人群相比,南非的耐药性可能更高。多拉韦林可用于肾脏或肝脏损害,并具有低潜在的药物-药物相互作用。摘要:多拉韦林是一种耐受性良好且有效的药物。需要与整合酶抑制剂的直接比较,以及在既往有NNRTI经历的情况下使用doravirine治疗的结果的证据,以更好地阐明哪些患者将从doravirine治疗中获益最多。
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来源期刊
Current Opinion in HIV and AIDS
Current Opinion in HIV and AIDS IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
7.40
自引率
7.30%
发文量
115
审稿时长
6-12 weeks
期刊介绍: Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in HIV and AIDS features hand-picked review articles from our team of expert editors. With six disciplines published across the year – including HIV and ageing, a HIV vaccine, and epidemiology – every issue also contains annotated reference detailing the merits of the most important papers.
期刊最新文献
Recent data on the role of antiretroviral therapy in weight gain and obesity in persons living with HIV. Anticipating HIV viral escape - resistance to active and passive immunization. Accelerating HIV vaccine development through meaningful engagement of local scientists and communities. Guiding HIV-1 vaccine development with preclinical nonhuman primate research. Discovery medicine - the HVTN's iterative approach to developing an HIV-1 broadly neutralizing vaccine.
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