In treatment-naive people, the two-drug combination dolutegravir/lamivudine (Dovato) shows similar outcomes to three-drug antiretroviral regimens, a study funded and partly designed by the drug's manufacturer, ViiV Healthcare, and its parent company, GlaxoSmithKline, showed. The network meta-analysis of 14 HIV drug regimens was published in AIDS.
At 48 weeks, virologic suppression rates were "broadly similar" between the study regimen and the three-drug combinations analyzed, with proportional differences ranging from -2.7% for dolutegravir/tenofovir alafenamide/emtricitabine to 7.3% for efavirenz/tenofovir disoproxil fumarate/emtricitabine.
Arguing in favor of two-drug therapy, the study authors noted that the longer lifespan of people living with HIV means more exposure to cumulative drug toxicities from antiretroviral treatment, and they suggested that two-drug regimens reduce that exposure. They also argued that randomized controlled trials to directly compare antiretroviral regimens are costly, making network analyses an appropriate substitute for such trials.
That said, study authors conceded that large differences in the distribution of effect modifiers may invalidate the results of such an analysis, and they allowed that different definitions of "networks" may produce different results. Nonetheless, the results of this particular network analysis support the use of dolutegravir/lamivudine instead of three-drug regimens, they concluded.