Randomized comparison of metabolic and renal effects of saquinavir/r or atazanavir/r plus tenofovir/emtricitabine in treatment‐naïve HIV‐1‐infected patients

Objectives The aim of the study was to compare the effects on lipids, body composition and renal function of once‐daily ritonavir‐boosted saquinavir (SQV/r) or atazanavir (ATV/r) in combination with tenofovir/emtricitabine (TDF/FTC) over 48 weeks. Methods An investigator‐initiated, randomized, open‐...

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Veröffentlicht in:HIV medicine 2011-11, Vol.12 (10), p.620-631
Hauptverfasser: Vrouenraets, SME, Wit, FWNM, Fernandez Garcia, E, Moyle, GJ, Jackson, AG, Allavena, C, Raffi, F, Jayaweera, DT, Mauss, S, Katlama, C, Fisher, M, Slama, L, Hardy, WD, DeJesus, E, van Eeden, A, Reiss, P
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container_end_page 631
container_issue 10
container_start_page 620
container_title HIV medicine
container_volume 12
creator Vrouenraets, SME
Wit, FWNM
Fernandez Garcia, E
Moyle, GJ
Jackson, AG
Allavena, C
Raffi, F
Jayaweera, DT
Mauss, S
Katlama, C
Fisher, M
Slama, L
Hardy, WD
DeJesus, E
van Eeden, A
Reiss, P
description Objectives The aim of the study was to compare the effects on lipids, body composition and renal function of once‐daily ritonavir‐boosted saquinavir (SQV/r) or atazanavir (ATV/r) in combination with tenofovir/emtricitabine (TDF/FTC) over 48 weeks. Methods An investigator‐initiated, randomized, open‐label, multinational trial comparing SQV/r 2000/100 mg and ATV/r 300/100 mg once daily, both in combination with TDF/FTC, in 123 treatment‐naïve HIV‐1‐infected adults was carried out. The primary endpoint was to demonstrate noninferiority of SQV/r compared with ATV/r with respect to the change in fasting cholesterol after 24 weeks. Secondary outcome measures were changes in metabolic abnormalities, body composition, renal function, and virological and immunological efficacy over 48 weeks. Patients who had used at least one dose of trial drug were included in the analysis. Results Data for 118 patients were analysed (57 patients on SQV/r and 61 on ATV/r). At week 24, changes in lipids were modest, without increases in triglycerides, including a significant rise in high‐density lipoprotein (HDL) cholesterol and a nonsignificant decrease in the total:HDL cholesterol ratio in both arms with no significant difference between arms. Lipid changes at week 48 were similar to the changes observed up to week 24, with no significant change in the homeostasis model assessment (HOMA) index. Adipose tissue increased regardless of the regimen, particularly in the peripheral compartment and to a lesser extent in the central abdominal compartment, with an increase in adipose tissue reaching statistical significance in the ATV/r arm. A slight decline in the estimated glomerular filtration rate (eGFR) was observed in both arms during the first 24 weeks, with no progression thereafter. The immunological and virological responses were similar over the 48 weeks. Conclusions Combined with TDF/FTC, both SQV/r 2000/100 mg and ATV/r 300/100 mg had comparable modest effects on lipids, had little effect on glucose metabolism, conserved adipose tissue, and similarly reduced eGFR. The virological efficacy was similar.
doi_str_mv 10.1111/j.1468-1293.2011.00941.x
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Methods An investigator‐initiated, randomized, open‐label, multinational trial comparing SQV/r 2000/100 mg and ATV/r 300/100 mg once daily, both in combination with TDF/FTC, in 123 treatment‐naïve HIV‐1‐infected adults was carried out. The primary endpoint was to demonstrate noninferiority of SQV/r compared with ATV/r with respect to the change in fasting cholesterol after 24 weeks. Secondary outcome measures were changes in metabolic abnormalities, body composition, renal function, and virological and immunological efficacy over 48 weeks. Patients who had used at least one dose of trial drug were included in the analysis. Results Data for 118 patients were analysed (57 patients on SQV/r and 61 on ATV/r). At week 24, changes in lipids were modest, without increases in triglycerides, including a significant rise in high‐density lipoprotein (HDL) cholesterol and a nonsignificant decrease in the total:HDL cholesterol ratio in both arms with no significant difference between arms. Lipid changes at week 48 were similar to the changes observed up to week 24, with no significant change in the homeostasis model assessment (HOMA) index. Adipose tissue increased regardless of the regimen, particularly in the peripheral compartment and to a lesser extent in the central abdominal compartment, with an increase in adipose tissue reaching statistical significance in the ATV/r arm. A slight decline in the estimated glomerular filtration rate (eGFR) was observed in both arms during the first 24 weeks, with no progression thereafter. The immunological and virological responses were similar over the 48 weeks. Conclusions Combined with TDF/FTC, both SQV/r 2000/100 mg and ATV/r 300/100 mg had comparable modest effects on lipids, had little effect on glucose metabolism, conserved adipose tissue, and similarly reduced eGFR. The virological efficacy was similar.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/j.1468-1293.2011.00941.x</identifier><identifier>PMID: 21819530</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject><![CDATA[Adenine - administration & dosage ; Adenine - analogs & derivatives ; Adenine - pharmacokinetics ; Adult ; adverse effects ; atazanavir ; Atazanavir Sulfate ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Deoxycytidine - pharmacokinetics ; Drug Administration Schedule ; Dyslipidemias - chemically induced ; Dyslipidemias - etiology ; Dyslipidemias - metabolism ; Emtricitabine ; Female ; Glomerular Filtration Rate ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - metabolism ; Humans ; Kidney Diseases ; Male ; Oligopeptides - administration & dosage ; Oligopeptides - pharmacokinetics ; Organophosphonates - administration & dosage ; Organophosphonates - pharmacokinetics ; Pyridines - administration & dosage ; Pyridines - pharmacokinetics ; saquinavir ; Saquinavir - administration & dosage ; Saquinavir - pharmacokinetics ; Tenofovir ; tenofovir/emtricitabine ; Treatment Outcome]]></subject><ispartof>HIV medicine, 2011-11, Vol.12 (10), p.620-631</ispartof><rights>2011 British HIV Association</rights><rights>2011 British HIV Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3681-b2d322c00c48999279ffbb07039374bf618e323f2587e3c09efc30ffab9763a53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1468-1293.2011.00941.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1468-1293.2011.00941.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21819530$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vrouenraets, SME</creatorcontrib><creatorcontrib>Wit, FWNM</creatorcontrib><creatorcontrib>Fernandez Garcia, E</creatorcontrib><creatorcontrib>Moyle, GJ</creatorcontrib><creatorcontrib>Jackson, AG</creatorcontrib><creatorcontrib>Allavena, C</creatorcontrib><creatorcontrib>Raffi, F</creatorcontrib><creatorcontrib>Jayaweera, DT</creatorcontrib><creatorcontrib>Mauss, S</creatorcontrib><creatorcontrib>Katlama, C</creatorcontrib><creatorcontrib>Fisher, M</creatorcontrib><creatorcontrib>Slama, L</creatorcontrib><creatorcontrib>Hardy, WD</creatorcontrib><creatorcontrib>DeJesus, E</creatorcontrib><creatorcontrib>van Eeden, A</creatorcontrib><creatorcontrib>Reiss, P</creatorcontrib><creatorcontrib>BASIC Study Group</creatorcontrib><title>Randomized comparison of metabolic and renal effects of saquinavir/r or atazanavir/r plus tenofovir/emtricitabine in treatment‐naïve HIV‐1‐infected patients</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description>Objectives The aim of the study was to compare the effects on lipids, body composition and renal function of once‐daily ritonavir‐boosted saquinavir (SQV/r) or atazanavir (ATV/r) in combination with tenofovir/emtricitabine (TDF/FTC) over 48 weeks. Methods An investigator‐initiated, randomized, open‐label, multinational trial comparing SQV/r 2000/100 mg and ATV/r 300/100 mg once daily, both in combination with TDF/FTC, in 123 treatment‐naïve HIV‐1‐infected adults was carried out. The primary endpoint was to demonstrate noninferiority of SQV/r compared with ATV/r with respect to the change in fasting cholesterol after 24 weeks. Secondary outcome measures were changes in metabolic abnormalities, body composition, renal function, and virological and immunological efficacy over 48 weeks. Patients who had used at least one dose of trial drug were included in the analysis. Results Data for 118 patients were analysed (57 patients on SQV/r and 61 on ATV/r). At week 24, changes in lipids were modest, without increases in triglycerides, including a significant rise in high‐density lipoprotein (HDL) cholesterol and a nonsignificant decrease in the total:HDL cholesterol ratio in both arms with no significant difference between arms. Lipid changes at week 48 were similar to the changes observed up to week 24, with no significant change in the homeostasis model assessment (HOMA) index. Adipose tissue increased regardless of the regimen, particularly in the peripheral compartment and to a lesser extent in the central abdominal compartment, with an increase in adipose tissue reaching statistical significance in the ATV/r arm. A slight decline in the estimated glomerular filtration rate (eGFR) was observed in both arms during the first 24 weeks, with no progression thereafter. The immunological and virological responses were similar over the 48 weeks. Conclusions Combined with TDF/FTC, both SQV/r 2000/100 mg and ATV/r 300/100 mg had comparable modest effects on lipids, had little effect on glucose metabolism, conserved adipose tissue, and similarly reduced eGFR. 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dosage</subject><subject>Oligopeptides - pharmacokinetics</subject><subject>Organophosphonates - administration &amp; dosage</subject><subject>Organophosphonates - pharmacokinetics</subject><subject>Pyridines - administration &amp; dosage</subject><subject>Pyridines - pharmacokinetics</subject><subject>saquinavir</subject><subject>Saquinavir - administration &amp; dosage</subject><subject>Saquinavir - pharmacokinetics</subject><subject>Tenofovir</subject><subject>tenofovir/emtricitabine</subject><subject>Treatment Outcome</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kd1qFjEQhoMotlZvQXLm0W7zs38BT6RYWygIop6G2XwTyMdusk2yte2Rl-A9eAFehHfilZjtX2DIzLwPkzAvIZSzmpdzvK950w0VF0rWgnFeM6YaXl8_I4dPwvO7vKlE14kD8iqlPWO8l4q9JAeCD1y1kh2S31_A78LsbnFHTZgXiC4FT4OlM2YYw-QMLQSN6GGiaC2anDY5weXqPFy5eBxpiBQy3MJjvUxrohl9sGFr4JyjM67Mcx6p8zRHhDyjz_9-_vLw988V0rPz76XgJZzfHin_WSC7wqTX5IWFKeGbh_uIfDv9-PXkrLr4_On85MNFZWQ38GoUOymEYcw0g1JK9MracWQ9k0r2zWg7PqAU0op26FEaptAayayFUfWdhFYekXf3c5cYLldMWc8uGZwm8BjWpBXr2rZV_Ua-fSDXccadXqKbId7ox70W4P098MNNePOkc6Y3__RebzbpzSa9-afv_NPXumyhJPI_eJOU8g</recordid><startdate>201111</startdate><enddate>201111</enddate><creator>Vrouenraets, SME</creator><creator>Wit, FWNM</creator><creator>Fernandez Garcia, E</creator><creator>Moyle, GJ</creator><creator>Jackson, AG</creator><creator>Allavena, C</creator><creator>Raffi, F</creator><creator>Jayaweera, DT</creator><creator>Mauss, S</creator><creator>Katlama, C</creator><creator>Fisher, M</creator><creator>Slama, L</creator><creator>Hardy, WD</creator><creator>DeJesus, E</creator><creator>van Eeden, A</creator><creator>Reiss, P</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201111</creationdate><title>Randomized comparison of metabolic and renal effects of saquinavir/r or atazanavir/r plus tenofovir/emtricitabine in treatment‐naïve HIV‐1‐infected patients</title><author>Vrouenraets, SME ; Wit, FWNM ; Fernandez Garcia, E ; Moyle, GJ ; Jackson, AG ; Allavena, C ; Raffi, F ; Jayaweera, DT ; Mauss, S ; Katlama, C ; Fisher, M ; Slama, L ; Hardy, WD ; DeJesus, E ; van Eeden, A ; Reiss, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3681-b2d322c00c48999279ffbb07039374bf618e323f2587e3c09efc30ffab9763a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenine - administration &amp; dosage</topic><topic>Adenine - analogs &amp; derivatives</topic><topic>Adenine - pharmacokinetics</topic><topic>Adult</topic><topic>adverse effects</topic><topic>atazanavir</topic><topic>Atazanavir Sulfate</topic><topic>Deoxycytidine - administration &amp; dosage</topic><topic>Deoxycytidine - analogs &amp; derivatives</topic><topic>Deoxycytidine - pharmacokinetics</topic><topic>Drug Administration Schedule</topic><topic>Dyslipidemias - chemically induced</topic><topic>Dyslipidemias - etiology</topic><topic>Dyslipidemias - metabolism</topic><topic>Emtricitabine</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - metabolism</topic><topic>Humans</topic><topic>Kidney Diseases</topic><topic>Male</topic><topic>Oligopeptides - administration &amp; dosage</topic><topic>Oligopeptides - pharmacokinetics</topic><topic>Organophosphonates - administration &amp; dosage</topic><topic>Organophosphonates - pharmacokinetics</topic><topic>Pyridines - administration &amp; dosage</topic><topic>Pyridines - pharmacokinetics</topic><topic>saquinavir</topic><topic>Saquinavir - administration &amp; dosage</topic><topic>Saquinavir - pharmacokinetics</topic><topic>Tenofovir</topic><topic>tenofovir/emtricitabine</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vrouenraets, SME</creatorcontrib><creatorcontrib>Wit, FWNM</creatorcontrib><creatorcontrib>Fernandez Garcia, E</creatorcontrib><creatorcontrib>Moyle, GJ</creatorcontrib><creatorcontrib>Jackson, AG</creatorcontrib><creatorcontrib>Allavena, C</creatorcontrib><creatorcontrib>Raffi, F</creatorcontrib><creatorcontrib>Jayaweera, DT</creatorcontrib><creatorcontrib>Mauss, S</creatorcontrib><creatorcontrib>Katlama, C</creatorcontrib><creatorcontrib>Fisher, M</creatorcontrib><creatorcontrib>Slama, L</creatorcontrib><creatorcontrib>Hardy, WD</creatorcontrib><creatorcontrib>DeJesus, E</creatorcontrib><creatorcontrib>van Eeden, A</creatorcontrib><creatorcontrib>Reiss, P</creatorcontrib><creatorcontrib>BASIC Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vrouenraets, SME</au><au>Wit, FWNM</au><au>Fernandez Garcia, E</au><au>Moyle, GJ</au><au>Jackson, AG</au><au>Allavena, C</au><au>Raffi, F</au><au>Jayaweera, DT</au><au>Mauss, S</au><au>Katlama, C</au><au>Fisher, M</au><au>Slama, L</au><au>Hardy, WD</au><au>DeJesus, E</au><au>van Eeden, A</au><au>Reiss, P</au><aucorp>BASIC Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized comparison of metabolic and renal effects of saquinavir/r or atazanavir/r plus tenofovir/emtricitabine in treatment‐naïve HIV‐1‐infected patients</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2011-11</date><risdate>2011</risdate><volume>12</volume><issue>10</issue><spage>620</spage><epage>631</epage><pages>620-631</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives The aim of the study was to compare the effects on lipids, body composition and renal function of once‐daily ritonavir‐boosted saquinavir (SQV/r) or atazanavir (ATV/r) in combination with tenofovir/emtricitabine (TDF/FTC) over 48 weeks. Methods An investigator‐initiated, randomized, open‐label, multinational trial comparing SQV/r 2000/100 mg and ATV/r 300/100 mg once daily, both in combination with TDF/FTC, in 123 treatment‐naïve HIV‐1‐infected adults was carried out. The primary endpoint was to demonstrate noninferiority of SQV/r compared with ATV/r with respect to the change in fasting cholesterol after 24 weeks. Secondary outcome measures were changes in metabolic abnormalities, body composition, renal function, and virological and immunological efficacy over 48 weeks. Patients who had used at least one dose of trial drug were included in the analysis. Results Data for 118 patients were analysed (57 patients on SQV/r and 61 on ATV/r). At week 24, changes in lipids were modest, without increases in triglycerides, including a significant rise in high‐density lipoprotein (HDL) cholesterol and a nonsignificant decrease in the total:HDL cholesterol ratio in both arms with no significant difference between arms. Lipid changes at week 48 were similar to the changes observed up to week 24, with no significant change in the homeostasis model assessment (HOMA) index. Adipose tissue increased regardless of the regimen, particularly in the peripheral compartment and to a lesser extent in the central abdominal compartment, with an increase in adipose tissue reaching statistical significance in the ATV/r arm. A slight decline in the estimated glomerular filtration rate (eGFR) was observed in both arms during the first 24 weeks, with no progression thereafter. The immunological and virological responses were similar over the 48 weeks. Conclusions Combined with TDF/FTC, both SQV/r 2000/100 mg and ATV/r 300/100 mg had comparable modest effects on lipids, had little effect on glucose metabolism, conserved adipose tissue, and similarly reduced eGFR. The virological efficacy was similar.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21819530</pmid><doi>10.1111/j.1468-1293.2011.00941.x</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record>
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source Wiley Free Content; MEDLINE; IngentaConnect Free/Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Adenine - administration & dosage
Adenine - analogs & derivatives
Adenine - pharmacokinetics
Adult
adverse effects
atazanavir
Atazanavir Sulfate
Deoxycytidine - administration & dosage
Deoxycytidine - analogs & derivatives
Deoxycytidine - pharmacokinetics
Drug Administration Schedule
Dyslipidemias - chemically induced
Dyslipidemias - etiology
Dyslipidemias - metabolism
Emtricitabine
Female
Glomerular Filtration Rate
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - metabolism
Humans
Kidney Diseases
Male
Oligopeptides - administration & dosage
Oligopeptides - pharmacokinetics
Organophosphonates - administration & dosage
Organophosphonates - pharmacokinetics
Pyridines - administration & dosage
Pyridines - pharmacokinetics
saquinavir
Saquinavir - administration & dosage
Saquinavir - pharmacokinetics
Tenofovir
tenofovir/emtricitabine
Treatment Outcome
title Randomized comparison of metabolic and renal effects of saquinavir/r or atazanavir/r plus tenofovir/emtricitabine in treatment‐naïve HIV‐1‐infected patients
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