The Most Important HIV Study at IDWeek 2015
October 29, 2015
After reporting my choice for the most important HIV study at ICAAC, I received this email from a colleague:
Now she has notoriously high standards -- hard to impress her -- but her opinion notwithstanding, I still think the STRIIVING study has some important messages we can apply to clinical practice today. So I stick by my choice.
Now let me see if I can meet her approval with an IDWeek 2015 (which took place earlier this month) selection. It's another HIV switch study, although this time with a twist. Instead of the usual switch-study population (first regimens, or only those with no history of virologic failure or resistance), it looked at a very different group -- patients who were virologically suppressed but highly treatment-experienced, all with 2-class (or more) resistance, and taking multiple pills a day with a darunavir-based regimen.
Subjects were then randomized to continue their current therapy or switch to the two-pill treatment of elvitegravir-cobicistat-FTC-TAF (ECF-TAF) plus darunavir 800 mg, both once daily. (Thanks to Greg Huhn, the presenting author, for sharing the slides.)
At week 24, 97% vs 91% of the ECF-TAF + DRV vs continued baseline regimen groups had HIV RNA < 50 cop/mL; at week 48, it was 94% and 76%, a significant advantage of ECF-TAF + DRV.
Some comments on this study:
The take home message from this study is that when ECF-TAF is approved, a subset of our patients who are taking complex regimens could safely switch to two pills a day -- ECF-TAF + darunavir.
Finding the right patients will take meticulous scrutiny of their historical genotypes. But of course that's why they pay us the big bucks!
Next year's meeting? October 26-30, New Orleans.
This article was provided by NEJM Journal Watch. NEJM Journal Watch is a publication of the Massachusetts Medical Society.
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