Brief Report: Switching to DOR/3TC/TDF Maintains HIV-1 Virologic Suppression Through Week 144 in the DRIVE-SHIFT Trial

Kumar, Princy; Johnson, Margaret; Molina, Jean‐Michel; Rizzardini, Giuliano; Cahn, Pedro; Bickel, Markus; Wan, Hong; Xu, Zhi Jin; Morais, Cristiana; Sklar, Peter; Greaves, Wayne

doi:10.1097/qai.0000000000002642

Cited by 31 publications

(35 citation statements)

References 17 publications

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“…DOR has not been studied in the setting of resistance mutations; clinical trials have compared this new NNRTI with boosted darunavir (bDRV) and efavirenz (EFV) in naive setting, [ 6 , 7 , 12 ] and have also explored its role in switching strategies. [ 8 , 13 ]…”

Section: Introductionmentioning

confidence: 99%

Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study

Mazzitelli¹,

Antoni

Castelli

et al. 2022

Medicine

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Use of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce.We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test.Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/ CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available (P = .008 and .01, respectively).Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.

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Section: Introductionmentioning

confidence: 99%

Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study

Mazzitelli¹,

Antoni

Castelli

et al. 2022

Medicine

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“…Results from clinical trials confirmed a good safety profile of DOR both on HIV virological control and on metabolic profile. [ 3 4 5 ] Moreover, when compared with other agents of the same class, DOR seems to have a better tolerability profile, less interactions with food or drugs, and a higher genetic barrier. [6] …”

Section: Introductionmentioning

confidence: 99%

Real life use of dolutegravir doravirine dual regimen in experienced elderly PLWH with multiple comorbidities and on polypharmacy

et al. 2021

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By increasing life expectancy of people living with HIV, the most clinical challenge is managing both drug-to-drug interactions and comorbidities (especially metabolic). Doravirine (DOR), a new non-nucleoside reverse transcriptase inhibitor, recently approved for the treatment of HIV, could be a good companion of dolutegravir (DTG) in a dual regimen for experienced elderly patients with multimorbidity and polypharmacy. We herein report our preliminary experience in a small cohort of elderly patients (>50 years of age) with multimorbidity and on polypharmacy who were switched to DOR/DTG dual regimen and followed-up for 3 months. The study was conducted at the Infectious and Tropical Diseases Unit of Padua University Hospital, Italy. Eighteen patients were included, 72.2% males and 27.8% postmenopausal women, mean age was of 61.3 years (7.6), 50% experienced AIDS events. Switches to DOR and DTG were mainly due to high cardiovascular and metabolic risk (72.2%), and interactions among comedications (50%). Antiretrovirals that subjects were switched off were mostly boosted protease inhibitors 66.7%. We observed a viral suppression among all subjects. Interestingly, we observed a statistically significant reduction in body mass index, body weight and waist circumference, eGFR, and a significant increase in serum creatinine levels. No significant changes in CD4+ T cell count was observed from the baseline. Lipid and fasting glucose values did not change significantly. To the best of our knowledge this is the first experience reporting real-life outcome of switch to DTG + DOR in elderly with multimorbidity and on polypharmacy. From our very preliminary data the dual combination of DTG and DOR could be a good treatment strategy for these subjects. However, our findings need to be validated on a greater number of patients.

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“…We read with interest the recently published results from the DRIVE-SHIFT trial, 1 whose results confirm the efficacy and safety of doravirine (DOR), in association with a 2-nucleoside reverse transcriptase inhibitor (NRTI) backbone, in virologically suppressed people living with HIV (PLWHIV). However, as we have learned in the past, results from clinical trials do not always translate directly to the “real-life” setting.…”

mentioning

confidence: 99%

Real-Life Safety of Doravirine in Treatment-Experienced, Virologically Suppressed PLWHIV

Ciccullo

D’Angelillo

Iannone

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Brief Report: Switching to DOR/3TC/TDF Maintains HIV-1 Virologic Suppression Through Week 144 in the DRIVE-SHIFT Trial

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 31 publications

References 17 publications

Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study

Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study

Real life use of dolutegravir doravirine dual regimen in experienced elderly PLWH with multiple comorbidities and on polypharmacy

Real-Life Safety of Doravirine in Treatment-Experienced, Virologically Suppressed PLWHIV

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