Real world use of dolutegravir two drug regimens
Since 2015, we prescribed dolutegravir (DTG)-based two drug regimens (DTG-2DR) for 620 people [total cohort 3133 (19.8%)]. Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed. In total, 620 people identified; 561 had complete data. 446 male (...
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| Veröffentlicht in: | AIDS (London) 2023-04, Vol.37 (5), p.785-788 |
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| creator | Bowman, Conor Ambrose, Alissa Kanitkar, Tanmay Flores, Katia Simoes, Pedro Hart, Jennifer Hunter, Alan Akodu, Jane Barber, Tristan J. |
| description | Since 2015, we prescribed dolutegravir (DTG)-based two drug regimens (DTG-2DR) for 620 people [total cohort 3133 (19.8%)].
Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed.
In total, 620 people identified; 561 had complete data. 446 male (79.5%); median age 54 years (interquartile range 46, 59). 343 (61.1%) MSM. Nine people who initiated naïvely achieved viral suppression (100%). 546/552 (99.0%) switched or continued and were suppressed at data censor. 460/552 (83.3%) received DTG-lamivudine (DTG/3TC), 74/552 (13.4%) received DTG-rilpivirine (DTG/RPV) and 18/552 (3.3%) received DTG-emtricitabine (DTG/FTC). 70 (12.5%) switched off DTG-2DR (55 DTG/3TC, 13 DTG/RPV, two DTG/FTC) due to side-effects. 41 episodes of blip (1 off >50 copies/ml) occurred in 30 people (5.3%). 11/41 on DTG-RPV [ n = 7 multi-tablet regimen (MTR), n = 4 single tablet regimen (STR)]. 27/41 DTG-3TC, 3/41 DTG/FTC ( n = 26 MTR, n = 4 STR). Six people (1.1%) failed (confirmed viral load >200 copies/ml or persistent low level viraemia) ( n = 4 DTG-3TC STR, n = 1 DTG-3TC MTR, n = 1 DTG-RPV MTR). Four failures due to low level viraemia, one due to non-adherence and one due to high viral load. Resistance tests performed for 5/6 - mutations detected only in latter person with high viral load failure (on DTG-3TC MTR) who developed triple class resistance.
Majority of experience is in DTG/3TC stable switch. Minority of patients developed side-effects. Low number of virological failures, one developed integrase inhibitor resistance. Viral failure associated with MTR, commensurate with trial data showing no failure with resistance if DTG/3TC STR used. Overall DTG-2DR demonstrates high efficacy in real-world setting. |
| doi_str_mv | 10.1097/QAD.0000000000003480 |
| format | Article |
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Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed.
In total, 620 people identified; 561 had complete data. 446 male (79.5%); median age 54 years (interquartile range 46, 59). 343 (61.1%) MSM. Nine people who initiated naïvely achieved viral suppression (100%). 546/552 (99.0%) switched or continued and were suppressed at data censor. 460/552 (83.3%) received DTG-lamivudine (DTG/3TC), 74/552 (13.4%) received DTG-rilpivirine (DTG/RPV) and 18/552 (3.3%) received DTG-emtricitabine (DTG/FTC). 70 (12.5%) switched off DTG-2DR (55 DTG/3TC, 13 DTG/RPV, two DTG/FTC) due to side-effects. 41 episodes of blip (1 off >50 copies/ml) occurred in 30 people (5.3%). 11/41 on DTG-RPV [ n = 7 multi-tablet regimen (MTR), n = 4 single tablet regimen (STR)]. 27/41 DTG-3TC, 3/41 DTG/FTC ( n = 26 MTR, n = 4 STR). Six people (1.1%) failed (confirmed viral load >200 copies/ml or persistent low level viraemia) ( n = 4 DTG-3TC STR, n = 1 DTG-3TC MTR, n = 1 DTG-RPV MTR). Four failures due to low level viraemia, one due to non-adherence and one due to high viral load. Resistance tests performed for 5/6 - mutations detected only in latter person with high viral load failure (on DTG-3TC MTR) who developed triple class resistance.
Majority of experience is in DTG/3TC stable switch. Minority of patients developed side-effects. Low number of virological failures, one developed integrase inhibitor resistance. Viral failure associated with MTR, commensurate with trial data showing no failure with resistance if DTG/3TC STR used. Overall DTG-2DR demonstrates high efficacy in real-world setting.</description><identifier>ISSN: 0269-9370</identifier><identifier>ISSN: 1473-5571</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0000000000003480</identifier><identifier>PMID: 36728219</identifier><language>eng</language><publisher>England: Lippincott Williams & Wilkins</publisher><subject>Anti-HIV Agents - therapeutic use ; Emtricitabine - therapeutic use ; Heterocyclic Compounds, 3-Ring - adverse effects ; HIV Infections - drug therapy ; Homosexuality, Male ; Humans ; Lamivudine - therapeutic use ; Male ; Middle Aged ; Pyridones - therapeutic use ; Sexual and Gender Minorities ; Tablets - therapeutic use ; Viremia - drug therapy</subject><ispartof>AIDS (London), 2023-04, Vol.37 (5), p.785-788</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3520-39ee4fcaba95e025a65764abb0e661dc76b8379f9b54c9410760f7e678370a623</citedby><cites>FETCH-LOGICAL-c3520-39ee4fcaba95e025a65764abb0e661dc76b8379f9b54c9410760f7e678370a623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36728219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bowman, Conor</creatorcontrib><creatorcontrib>Ambrose, Alissa</creatorcontrib><creatorcontrib>Kanitkar, Tanmay</creatorcontrib><creatorcontrib>Flores, Katia</creatorcontrib><creatorcontrib>Simoes, Pedro</creatorcontrib><creatorcontrib>Hart, Jennifer</creatorcontrib><creatorcontrib>Hunter, Alan</creatorcontrib><creatorcontrib>Akodu, Jane</creatorcontrib><creatorcontrib>Barber, Tristan J.</creatorcontrib><title>Real world use of dolutegravir two drug regimens</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>Since 2015, we prescribed dolutegravir (DTG)-based two drug regimens (DTG-2DR) for 620 people [total cohort 3133 (19.8%)].
Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed.
In total, 620 people identified; 561 had complete data. 446 male (79.5%); median age 54 years (interquartile range 46, 59). 343 (61.1%) MSM. Nine people who initiated naïvely achieved viral suppression (100%). 546/552 (99.0%) switched or continued and were suppressed at data censor. 460/552 (83.3%) received DTG-lamivudine (DTG/3TC), 74/552 (13.4%) received DTG-rilpivirine (DTG/RPV) and 18/552 (3.3%) received DTG-emtricitabine (DTG/FTC). 70 (12.5%) switched off DTG-2DR (55 DTG/3TC, 13 DTG/RPV, two DTG/FTC) due to side-effects. 41 episodes of blip (1 off >50 copies/ml) occurred in 30 people (5.3%). 11/41 on DTG-RPV [ n = 7 multi-tablet regimen (MTR), n = 4 single tablet regimen (STR)]. 27/41 DTG-3TC, 3/41 DTG/FTC ( n = 26 MTR, n = 4 STR). Six people (1.1%) failed (confirmed viral load >200 copies/ml or persistent low level viraemia) ( n = 4 DTG-3TC STR, n = 1 DTG-3TC MTR, n = 1 DTG-RPV MTR). Four failures due to low level viraemia, one due to non-adherence and one due to high viral load. Resistance tests performed for 5/6 - mutations detected only in latter person with high viral load failure (on DTG-3TC MTR) who developed triple class resistance.
Majority of experience is in DTG/3TC stable switch. Minority of patients developed side-effects. Low number of virological failures, one developed integrase inhibitor resistance. Viral failure associated with MTR, commensurate with trial data showing no failure with resistance if DTG/3TC STR used. Overall DTG-2DR demonstrates high efficacy in real-world setting.</description><subject>Anti-HIV Agents - therapeutic use</subject><subject>Emtricitabine - therapeutic use</subject><subject>Heterocyclic Compounds, 3-Ring - adverse effects</subject><subject>HIV Infections - drug therapy</subject><subject>Homosexuality, Male</subject><subject>Humans</subject><subject>Lamivudine - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pyridones - therapeutic use</subject><subject>Sexual and Gender Minorities</subject><subject>Tablets - therapeutic use</subject><subject>Viremia - drug therapy</subject><issn>0269-9370</issn><issn>1473-5571</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkN1LwzAUxYMobk7_A5E--tJ5kzRJ8zj8hoEo-hzS9narputMWov_vdXND7wvBw7nnAs_Qo4pTClodXY_u5jCn-NJCjtkTBPFYyEU3SVjYFLHmisYkYMQnoeQgDTdJyMuFUsZ1WMCD2hd1DfeFVEXMGrKqGhc1-LC27fKR23fRIXvFpHHRVXjKhySvdK6gEdbnZCnq8vH85t4fnd9ez6bxzkXDGKuEZMyt5nVAoEJK4WSic0yQClpkSuZpVzpUmciyXVCQUkoFUo1uGAl4xNyutld--a1w9Caugo5OmdX2HTBMKWo5qnWcogmm2jumxA8lmbtq9r6d0PBfLIyAyvzn9VQO9l-6LIai5_SN5zf3b5xLfrw4roevVkOxNrl1x4DDjEDxiEBCvHgUOAfOoFx9A</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Bowman, Conor</creator><creator>Ambrose, Alissa</creator><creator>Kanitkar, Tanmay</creator><creator>Flores, Katia</creator><creator>Simoes, Pedro</creator><creator>Hart, Jennifer</creator><creator>Hunter, Alan</creator><creator>Akodu, Jane</creator><creator>Barber, Tristan J.</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Real world use of dolutegravir two drug regimens</title><author>Bowman, Conor ; Ambrose, Alissa ; Kanitkar, Tanmay ; Flores, Katia ; Simoes, Pedro ; Hart, Jennifer ; Hunter, Alan ; Akodu, Jane ; Barber, Tristan J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3520-39ee4fcaba95e025a65764abb0e661dc76b8379f9b54c9410760f7e678370a623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-HIV Agents - therapeutic use</topic><topic>Emtricitabine - therapeutic use</topic><topic>Heterocyclic Compounds, 3-Ring - adverse effects</topic><topic>HIV Infections - drug therapy</topic><topic>Homosexuality, Male</topic><topic>Humans</topic><topic>Lamivudine - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pyridones - therapeutic use</topic><topic>Sexual and Gender Minorities</topic><topic>Tablets - therapeutic use</topic><topic>Viremia - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bowman, Conor</creatorcontrib><creatorcontrib>Ambrose, Alissa</creatorcontrib><creatorcontrib>Kanitkar, Tanmay</creatorcontrib><creatorcontrib>Flores, Katia</creatorcontrib><creatorcontrib>Simoes, Pedro</creatorcontrib><creatorcontrib>Hart, Jennifer</creatorcontrib><creatorcontrib>Hunter, Alan</creatorcontrib><creatorcontrib>Akodu, Jane</creatorcontrib><creatorcontrib>Barber, Tristan J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bowman, Conor</au><au>Ambrose, Alissa</au><au>Kanitkar, Tanmay</au><au>Flores, Katia</au><au>Simoes, Pedro</au><au>Hart, Jennifer</au><au>Hunter, Alan</au><au>Akodu, Jane</au><au>Barber, Tristan J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real world use of dolutegravir two drug regimens</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>37</volume><issue>5</issue><spage>785</spage><epage>788</epage><pages>785-788</pages><issn>0269-9370</issn><issn>1473-5571</issn><eissn>1473-5571</eissn><abstract>Since 2015, we prescribed dolutegravir (DTG)-based two drug regimens (DTG-2DR) for 620 people [total cohort 3133 (19.8%)].
Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed.
In total, 620 people identified; 561 had complete data. 446 male (79.5%); median age 54 years (interquartile range 46, 59). 343 (61.1%) MSM. Nine people who initiated naïvely achieved viral suppression (100%). 546/552 (99.0%) switched or continued and were suppressed at data censor. 460/552 (83.3%) received DTG-lamivudine (DTG/3TC), 74/552 (13.4%) received DTG-rilpivirine (DTG/RPV) and 18/552 (3.3%) received DTG-emtricitabine (DTG/FTC). 70 (12.5%) switched off DTG-2DR (55 DTG/3TC, 13 DTG/RPV, two DTG/FTC) due to side-effects. 41 episodes of blip (1 off >50 copies/ml) occurred in 30 people (5.3%). 11/41 on DTG-RPV [ n = 7 multi-tablet regimen (MTR), n = 4 single tablet regimen (STR)]. 27/41 DTG-3TC, 3/41 DTG/FTC ( n = 26 MTR, n = 4 STR). Six people (1.1%) failed (confirmed viral load >200 copies/ml or persistent low level viraemia) ( n = 4 DTG-3TC STR, n = 1 DTG-3TC MTR, n = 1 DTG-RPV MTR). Four failures due to low level viraemia, one due to non-adherence and one due to high viral load. Resistance tests performed for 5/6 - mutations detected only in latter person with high viral load failure (on DTG-3TC MTR) who developed triple class resistance.
Majority of experience is in DTG/3TC stable switch. Minority of patients developed side-effects. Low number of virological failures, one developed integrase inhibitor resistance. Viral failure associated with MTR, commensurate with trial data showing no failure with resistance if DTG/3TC STR used. Overall DTG-2DR demonstrates high efficacy in real-world setting.</abstract><cop>England</cop><pub>Lippincott Williams & Wilkins</pub><pmid>36728219</pmid><doi>10.1097/QAD.0000000000003480</doi><tpages>4</tpages></addata></record> |
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| ispartof | AIDS (London), 2023-04, Vol.37 (5), p.785-788 |
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| subjects | Anti-HIV Agents - therapeutic use Emtricitabine - therapeutic use Heterocyclic Compounds, 3-Ring - adverse effects HIV Infections - drug therapy Homosexuality, Male Humans Lamivudine - therapeutic use Male Middle Aged Pyridones - therapeutic use Sexual and Gender Minorities Tablets - therapeutic use Viremia - drug therapy |
| title | Real world use of dolutegravir two drug regimens |
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