Roberto Rossotti, Federico D'Amico, Nicholas Brian Bana, Alice Nava, Leonardo Francesco Rezzonico, Alessandro Raimondi, Diana Fanti, Leonardo Gerolamo Chianura, Maria Cristina Moioli, Chiara Vismara, Massimo Puoti
{"title":"多拉韦林与多鲁曲韦双联疗法与其他基于多鲁曲韦的双联疗法的耐久性比较。","authors":"Roberto Rossotti, Federico D'Amico, Nicholas Brian Bana, Alice Nava, Leonardo Francesco Rezzonico, Alessandro Raimondi, Diana Fanti, Leonardo Gerolamo Chianura, Maria Cristina Moioli, Chiara Vismara, Massimo Puoti","doi":"10.1111/hiv.13615","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective<b>s</b></h3>\n \n <p>The availability of doravirine (DOR) allowed clinicians to prescribe a dolutegravir (DTG)-based two-drug regimen (2DR) in individuals not eligible to receive lamivudine (3TC) or rilpivirine (RPV). The aims of this study were to describe the durability of DTG + DOR compared with DTG/3TC and DTG/RPV and the rate of virological failure and target not-detected maintenance over time.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective, monocentric analysis included all subjects who started a DTG-based 2DR from 2018 to 2022 as a simplification. Descriptive statistics and non-parametric tests to describe and compare the groups were applied. Kaplan–Meier probability curves and Cox regression models for regimens durability were used.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study enrolled 710 individuals: 499 treated with DTG/3TC, 140 with DTG/RPV, and 71 with DTG + DOR. A 2DR with DOR was prescribed to older subjects who had a longer infection, greater exposure to different antiretroviral regimens, a higher proportion of resistance-associated mutations, and a worse immune-virologic status. Over a cumulative follow-up of 68 152 weeks, 42 discontinuations were registered (5.9%). DTG + DOR had a risk of treatment interruption of 7.8% at 48 weeks and 9.8% at 96 weeks, significantly higher than the other 2DRs. In the multivariate Cox model, DTG + DOR and DTG/RPV were significantly associated with discontinuation. The maintenance of target not detected during follow-up was similar among groups. The rate of virological failure was higher for DTG + DOR through different event definitions.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>DTG + DOR durability was high over a long follow-up albeit lower than for other 2DRs. This combination might be an effective option in people with HIV that has proven difficult to treat.</p>\n </section>\n </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Durability of doravirine with dolutegravir dual regimen compared with other dolutegravir-based dual combinations\",\"authors\":\"Roberto Rossotti, Federico D'Amico, Nicholas Brian Bana, Alice Nava, Leonardo Francesco Rezzonico, Alessandro Raimondi, Diana Fanti, Leonardo Gerolamo Chianura, Maria Cristina Moioli, Chiara Vismara, Massimo Puoti\",\"doi\":\"10.1111/hiv.13615\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective<b>s</b></h3>\\n \\n <p>The availability of doravirine (DOR) allowed clinicians to prescribe a dolutegravir (DTG)-based two-drug regimen (2DR) in individuals not eligible to receive lamivudine (3TC) or rilpivirine (RPV). The aims of this study were to describe the durability of DTG + DOR compared with DTG/3TC and DTG/RPV and the rate of virological failure and target not-detected maintenance over time.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective, monocentric analysis included all subjects who started a DTG-based 2DR from 2018 to 2022 as a simplification. Descriptive statistics and non-parametric tests to describe and compare the groups were applied. Kaplan–Meier probability curves and Cox regression models for regimens durability were used.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The study enrolled 710 individuals: 499 treated with DTG/3TC, 140 with DTG/RPV, and 71 with DTG + DOR. A 2DR with DOR was prescribed to older subjects who had a longer infection, greater exposure to different antiretroviral regimens, a higher proportion of resistance-associated mutations, and a worse immune-virologic status. Over a cumulative follow-up of 68 152 weeks, 42 discontinuations were registered (5.9%). DTG + DOR had a risk of treatment interruption of 7.8% at 48 weeks and 9.8% at 96 weeks, significantly higher than the other 2DRs. In the multivariate Cox model, DTG + DOR and DTG/RPV were significantly associated with discontinuation. The maintenance of target not detected during follow-up was similar among groups. The rate of virological failure was higher for DTG + DOR through different event definitions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>DTG + DOR durability was high over a long follow-up albeit lower than for other 2DRs. 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Durability of doravirine with dolutegravir dual regimen compared with other dolutegravir-based dual combinations
Objectives
The availability of doravirine (DOR) allowed clinicians to prescribe a dolutegravir (DTG)-based two-drug regimen (2DR) in individuals not eligible to receive lamivudine (3TC) or rilpivirine (RPV). The aims of this study were to describe the durability of DTG + DOR compared with DTG/3TC and DTG/RPV and the rate of virological failure and target not-detected maintenance over time.
Methods
This retrospective, monocentric analysis included all subjects who started a DTG-based 2DR from 2018 to 2022 as a simplification. Descriptive statistics and non-parametric tests to describe and compare the groups were applied. Kaplan–Meier probability curves and Cox regression models for regimens durability were used.
Results
The study enrolled 710 individuals: 499 treated with DTG/3TC, 140 with DTG/RPV, and 71 with DTG + DOR. A 2DR with DOR was prescribed to older subjects who had a longer infection, greater exposure to different antiretroviral regimens, a higher proportion of resistance-associated mutations, and a worse immune-virologic status. Over a cumulative follow-up of 68 152 weeks, 42 discontinuations were registered (5.9%). DTG + DOR had a risk of treatment interruption of 7.8% at 48 weeks and 9.8% at 96 weeks, significantly higher than the other 2DRs. In the multivariate Cox model, DTG + DOR and DTG/RPV were significantly associated with discontinuation. The maintenance of target not detected during follow-up was similar among groups. The rate of virological failure was higher for DTG + DOR through different event definitions.
Conclusions
DTG + DOR durability was high over a long follow-up albeit lower than for other 2DRs. This combination might be an effective option in people with HIV that has proven difficult to treat.
期刊介绍:
HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.