HIV Drug Updates
Complera, the newest single tablet regimen (STR), comprised of rilpivirine (Edurant) plus emtricitabine/tenofovir (Truvada), continues to hold its own. Previously, it had been shown to be non-inferior to Atripla, another STR, made of efavirenz (Sustiva) plus emtricitabine/tenofovir. This time, however, it has been shown to maintain an undetectable viral load (of less than 50 copies/mL) in people who were switching from a Norvir-boosted protease inhibitor (PI) combination.
These were 24-week results in nearly 500 individuals, of whom two-thirds were switched to Complera and the rest maintained on their PI regimen. Overall total cholesterol, LDL ("bad cholesterol"), and triglycerides decreased to a greater extent among those switched than on those maintained on their PI. The differences were statistically significant.
"We all know that regimen simplification improves quality of life," said Frank Palella, M.D., of Northwestern University when he presented these results from the SPIRIT study.
Also continuing to do well: the still investigational elvitegravir and dolutegravir, both integrase inhibitor medications (INSTIs). In 96-week results from Study 145, elvitegravir continued to be non-inferior (as it was in earlier 48-week results) to Isentress, the only INSTI currently on the market. Development of INSTI drug resistance was low (about 7%) and similar with both medications. The 700 participants in this study were treatment-experienced, so they were less likely to achieve undetectable viral load. Overall, 47.6% of the 351 participants on dolutegravir had undetectable viral loads, compared to 45% of those on Isentress.
In 48-week results from the SPRING-2 study, dolutegravir was as effective as Isentress, with 88% vs. 85% of participants in the two groups achieving undetectable viral load. The participants were treatment-naive (first time on HIV therapy). See more dolutegravir news in this issue.