Safety and Efficacy of Dolutegravir in Treatment-Experienced Subjects With Raltegravir-Resistant HIV Type 1 Infection: 24-Week Results of the VIKING Study

Background. Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1—infected subjects with genotypic evidence of RAL re...

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Veröffentlicht in:The Journal of infectious diseases 2013-03, Vol.207 (5), p.740-748
Hauptverfasser: Eron, Joseph J., Clotet, Bonaventura, Durant, Jacques, Katlama, Christine, Kumar, Princy, Lazzarin, Adriano, Poizot-Martin, Isabelle, Richmond, Gary, Soriano, Vincent, Ait-Khaled, Mounir, Fujiwara, Tamio, Huang, Jenny, Min, Sherene, Vavro, Cindy, Yeo, Jane
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container_issue 5
container_start_page 740
container_title The Journal of infectious diseases
container_volume 207
creator Eron, Joseph J.
Clotet, Bonaventura
Durant, Jacques
Katlama, Christine
Kumar, Princy
Lazzarin, Adriano
Poizot-Martin, Isabelle
Richmond, Gary
Soriano, Vincent
Ait-Khaled, Mounir
Fujiwara, Tamio
Huang, Jenny
Min, Sherene
Vavro, Cindy
Yeo, Jane
description Background. Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1—infected subjects with genotypic evidence of RAL resistance. Methods. Subjects received DTG 50 mg once daily (cohort I) or 50 mg twice daily (cohort II) while continuing a failing regimen (without RAL) through day 10, after which the background regimen was optimized, when feasible, for cohort I, and at least 1 fully active drug was mandated for cohort II. The primary efficacy end point was the proportion of subjects on day 11 in whom the plasma HIV-1 RNA load decreased by ≥0.7 log10 copies/mL from baseline or was
doi_str_mv 10.1093/infdis/jis750
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Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1—infected subjects with genotypic evidence of RAL resistance. Methods. Subjects received DTG 50 mg once daily (cohort I) or 50 mg twice daily (cohort II) while continuing a failing regimen (without RAL) through day 10, after which the background regimen was optimized, when feasible, for cohort I, and at least 1 fully active drug was mandated for cohort II. The primary efficacy end point was the proportion of subjects on day 11 in whom the plasma HIV-1 RNA load decreased by ≥0.7 log10 copies/mL from baseline or was &lt;400 copies/mL. Results. A rapid antiviral response was observed. More subjects achieved the primary end point in cohort II (23 of 24 [96%]), compared with cohort I (21 of 27 [78%]) at day 11. At week 24, 41% and 75% of subjects had an HIV-1 RNA load of &lt;50 copies/mL in cohorts I and II, respectively. Further integrase genotypic evolution was uncommon. Dolutegravir had a good, similar safety profile with each dosing regimen. Conclusion. Dolutegravir 50 mg twice daily with an optimized background provided greater and more durable benefit than the once-daily regimen. These data are the first clinical demonstration of the activity of any integrase inhibitor in subjects with HIV-1 resistant to RAL.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/jis750</identifier><identifier>PMID: 23225901</identifier><identifier>CODEN: JIDIAQ</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Aged ; Anti-HIV Agents - administration &amp; dosage ; Anti-HIV Agents - adverse effects ; Anti-HIV Agents - pharmacology ; Antiretroviral Therapy, Highly Active - methods ; Biological and medical sciences ; Drug Resistance, Viral ; Female ; Fundamental and applied biological sciences. Psychology ; Heterocyclic Compounds, 3-Ring - administration &amp; dosage ; Heterocyclic Compounds, 3-Ring - adverse effects ; Heterocyclic Compounds, 3-Ring - pharmacology ; HIV Infections - drug therapy ; HIV Infections - virology ; HIV-1 - drug effects ; HIV-1 - isolation &amp; purification ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Infectious diseases ; Major and Brief Reports ; MAJOR ARTICLES AND BRIEF REPORTS ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; Pilot Projects ; Plasma - virology ; Pyrrolidinones - pharmacology ; Raltegravir Potassium ; RNA, Viral - blood ; Treatment Outcome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load ; Virology ; Young Adult</subject><ispartof>The Journal of infectious diseases, 2013-03, Vol.207 (5), p.740-748</ispartof><rights>Copyright © 2013 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>2014 INIST-CNRS</rights><rights>The Author 2012. 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Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1—infected subjects with genotypic evidence of RAL resistance. Methods. Subjects received DTG 50 mg once daily (cohort I) or 50 mg twice daily (cohort II) while continuing a failing regimen (without RAL) through day 10, after which the background regimen was optimized, when feasible, for cohort I, and at least 1 fully active drug was mandated for cohort II. The primary efficacy end point was the proportion of subjects on day 11 in whom the plasma HIV-1 RNA load decreased by ≥0.7 log10 copies/mL from baseline or was &lt;400 copies/mL. Results. A rapid antiviral response was observed. More subjects achieved the primary end point in cohort II (23 of 24 [96%]), compared with cohort I (21 of 27 [78%]) at day 11. At week 24, 41% and 75% of subjects had an HIV-1 RNA load of &lt;50 copies/mL in cohorts I and II, respectively. Further integrase genotypic evolution was uncommon. Dolutegravir had a good, similar safety profile with each dosing regimen. Conclusion. Dolutegravir 50 mg twice daily with an optimized background provided greater and more durable benefit than the once-daily regimen. These data are the first clinical demonstration of the activity of any integrase inhibitor in subjects with HIV-1 resistant to RAL.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-HIV Agents - administration &amp; dosage</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - pharmacology</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Biological and medical sciences</subject><subject>Drug Resistance, Viral</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heterocyclic Compounds, 3-Ring - administration &amp; dosage</subject><subject>Heterocyclic Compounds, 3-Ring - adverse effects</subject><subject>Heterocyclic Compounds, 3-Ring - pharmacology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - drug effects</subject><subject>HIV-1 - isolation &amp; purification</subject><subject>Human immunodeficiency virus 1</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Major and Brief Reports</subject><subject>MAJOR ARTICLES AND BRIEF REPORTS</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Pilot Projects</subject><subject>Plasma - virology</subject><subject>Pyrrolidinones - pharmacology</subject><subject>Raltegravir Potassium</subject><subject>RNA, Viral - blood</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Young Adult</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpV0UFv0zAYBmALgVg3OHIE-YLEJcyO7bjhgIRG2SImkNayHSPH-by6pE6xnWn5K_xaDOmqcbJkP99rWy9Cryh5T0nJTq0zrQ2nGxukIE_QjAoms6Kg7CmaEZLnGZ2X5RE6DmFDCOGskM_RUc7yXJSEztDvpTIQR6xcixfGWK30iHuDP_fdEOHWqzvrsXV45UHFLbiYLe534C04DS1eDs0GdAz4xsY1vlLdw0h2BcGGqFzEF9U1Xo07wBRXziRte_cB5zy7AfiJkxu6FJCujGvA19XX6ts5XsahHV-gZ0Z1AV7u1xP048tidXaRXX4_r84-XWaayzxmXMxLpgiXrFSlIsIYTYByKUkjtWhEkxfUSCK11lwQDroBpRnMW9qKPO2xE_Rxyt0NzRZanT7pVVfvvN0qP9a9svX_J86u69v-rmaiYIzIFPBuH-D7XwOEWG9t0NB1ykE_hJoWgheSzHORaDZR7fsQPJjDNZTUf_uspz7rqc_k3zx-20E_FJjA2z1QQavOeOV0Gj84SSnh_9zryW1C7P2jHCa45Iz9AdPStrc</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Eron, Joseph J.</creator><creator>Clotet, Bonaventura</creator><creator>Durant, Jacques</creator><creator>Katlama, Christine</creator><creator>Kumar, Princy</creator><creator>Lazzarin, Adriano</creator><creator>Poizot-Martin, Isabelle</creator><creator>Richmond, Gary</creator><creator>Soriano, Vincent</creator><creator>Ait-Khaled, Mounir</creator><creator>Fujiwara, Tamio</creator><creator>Huang, Jenny</creator><creator>Min, Sherene</creator><creator>Vavro, Cindy</creator><creator>Yeo, Jane</creator><general>Oxford University Press</general><scope>IQODW</scope><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>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20130301</creationdate><title>Safety and Efficacy of Dolutegravir in Treatment-Experienced Subjects With Raltegravir-Resistant HIV Type 1 Infection: 24-Week Results of the VIKING Study</title><author>Eron, Joseph J. ; Clotet, Bonaventura ; Durant, Jacques ; Katlama, Christine ; Kumar, Princy ; Lazzarin, Adriano ; Poizot-Martin, Isabelle ; Richmond, Gary ; Soriano, Vincent ; Ait-Khaled, Mounir ; Fujiwara, Tamio ; Huang, Jenny ; Min, Sherene ; Vavro, Cindy ; Yeo, Jane</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-45893a04739a9a05ffc0e14770b7c5b5b261f707ccc4504ecbeac3e8d1d52cc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anti-HIV Agents - administration &amp; dosage</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - pharmacology</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Biological and medical sciences</topic><topic>Drug Resistance, Viral</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heterocyclic Compounds, 3-Ring - administration &amp; dosage</topic><topic>Heterocyclic Compounds, 3-Ring - adverse effects</topic><topic>Heterocyclic Compounds, 3-Ring - pharmacology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - drug effects</topic><topic>HIV-1 - isolation &amp; purification</topic><topic>Human immunodeficiency virus 1</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Major and Brief Reports</topic><topic>MAJOR ARTICLES AND BRIEF REPORTS</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Pilot Projects</topic><topic>Plasma - virology</topic><topic>Pyrrolidinones - pharmacology</topic><topic>Raltegravir Potassium</topic><topic>RNA, Viral - blood</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral Load</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eron, Joseph J.</creatorcontrib><creatorcontrib>Clotet, Bonaventura</creatorcontrib><creatorcontrib>Durant, Jacques</creatorcontrib><creatorcontrib>Katlama, Christine</creatorcontrib><creatorcontrib>Kumar, Princy</creatorcontrib><creatorcontrib>Lazzarin, Adriano</creatorcontrib><creatorcontrib>Poizot-Martin, Isabelle</creatorcontrib><creatorcontrib>Richmond, Gary</creatorcontrib><creatorcontrib>Soriano, Vincent</creatorcontrib><creatorcontrib>Ait-Khaled, Mounir</creatorcontrib><creatorcontrib>Fujiwara, Tamio</creatorcontrib><creatorcontrib>Huang, Jenny</creatorcontrib><creatorcontrib>Min, Sherene</creatorcontrib><creatorcontrib>Vavro, Cindy</creatorcontrib><creatorcontrib>Yeo, Jane</creatorcontrib><creatorcontrib>VIKING Study Group</creatorcontrib><creatorcontrib>for the VIKING Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eron, Joseph J.</au><au>Clotet, Bonaventura</au><au>Durant, Jacques</au><au>Katlama, Christine</au><au>Kumar, Princy</au><au>Lazzarin, Adriano</au><au>Poizot-Martin, Isabelle</au><au>Richmond, Gary</au><au>Soriano, Vincent</au><au>Ait-Khaled, Mounir</au><au>Fujiwara, Tamio</au><au>Huang, Jenny</au><au>Min, Sherene</au><au>Vavro, Cindy</au><au>Yeo, Jane</au><aucorp>VIKING Study Group</aucorp><aucorp>for the VIKING Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Efficacy of Dolutegravir in Treatment-Experienced Subjects With Raltegravir-Resistant HIV Type 1 Infection: 24-Week Results of the VIKING Study</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>207</volume><issue>5</issue><spage>740</spage><epage>748</epage><pages>740-748</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>Background. Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1—infected subjects with genotypic evidence of RAL resistance. Methods. Subjects received DTG 50 mg once daily (cohort I) or 50 mg twice daily (cohort II) while continuing a failing regimen (without RAL) through day 10, after which the background regimen was optimized, when feasible, for cohort I, and at least 1 fully active drug was mandated for cohort II. The primary efficacy end point was the proportion of subjects on day 11 in whom the plasma HIV-1 RNA load decreased by ≥0.7 log10 copies/mL from baseline or was &lt;400 copies/mL. Results. A rapid antiviral response was observed. More subjects achieved the primary end point in cohort II (23 of 24 [96%]), compared with cohort I (21 of 27 [78%]) at day 11. At week 24, 41% and 75% of subjects had an HIV-1 RNA load of &lt;50 copies/mL in cohorts I and II, respectively. Further integrase genotypic evolution was uncommon. Dolutegravir had a good, similar safety profile with each dosing regimen. Conclusion. Dolutegravir 50 mg twice daily with an optimized background provided greater and more durable benefit than the once-daily regimen. These data are the first clinical demonstration of the activity of any integrase inhibitor in subjects with HIV-1 resistant to RAL.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>23225901</pmid><doi>10.1093/infdis/jis750</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection
subjects Adult
Aged
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - adverse effects
Anti-HIV Agents - pharmacology
Antiretroviral Therapy, Highly Active - methods
Biological and medical sciences
Drug Resistance, Viral
Female
Fundamental and applied biological sciences. Psychology
Heterocyclic Compounds, 3-Ring - administration & dosage
Heterocyclic Compounds, 3-Ring - adverse effects
Heterocyclic Compounds, 3-Ring - pharmacology
HIV Infections - drug therapy
HIV Infections - virology
HIV-1 - drug effects
HIV-1 - isolation & purification
Human immunodeficiency virus 1
Human viral diseases
Humans
Infectious diseases
Major and Brief Reports
MAJOR ARTICLES AND BRIEF REPORTS
Male
Medical sciences
Microbiology
Middle Aged
Miscellaneous
Pilot Projects
Plasma - virology
Pyrrolidinones - pharmacology
Raltegravir Potassium
RNA, Viral - blood
Treatment Outcome
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral Load
Virology
Young Adult
title Safety and Efficacy of Dolutegravir in Treatment-Experienced Subjects With Raltegravir-Resistant HIV Type 1 Infection: 24-Week Results of the VIKING Study
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