Comparison of atazanavir with lopinavir/ritonavir in patients with prior protease inhibitor failure: a randomized multinational trial

Cohen, Calvin; Nieto‐Cisneros, Leopoldo; Zala, Carlos; Fessel, W. J.; González‐García, Juan; Gładysz, Andrzej; McGovern, Rachel T.; Adler, Edward; McLaren, Colin

doi:10.1185/030079905x65439

Cited by 85 publications

(48 citation statements)

References 28 publications

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“…The most pronounced effect on triglyceride levels occurs with fulldose ritonavir; somewhat reduced effects are associated with ritonavir-boosted PIs; and a neutral effect is noted with unboosted atazanavir. 44 Among "older" PIs, statistically significant elevations of triglyceride levels are observed with ritonavir and lopinavir/ritonavir. 16,38,45 Compared with lopinavir/ ritonavir, boosted darunavir has been shown to induce less dyslipidemia.…”

Section: ■■ Personalized Medication Selection Based On Hiv Populationmentioning

confidence: 99%

Use of HMG-CoA Reductase Inhibitors in the HIV Population: Implications for Individualized Treatment Selection

Advani

Patel²,

Pichardo³

et al. 2014

JMCP

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Section: ■■ Personalized Medication Selection Based On Hiv Populationmentioning

confidence: 99%

Use of HMG-CoA Reductase Inhibitors in the HIV Population: Implications for Individualized Treatment Selection

Advani

Patel²,

Pichardo³

et al. 2014

JMCP

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“…Another study showed that patients who had failed on one PI regimen could be rescued with HAART containing unboosted ATV; however, greater viral suppression was seen in patients given LPV/r. 34 This 48-week, open-label study followed 290 patients randomized to receive a two NRTI backbone + either ATV or LPV/r. Both regimens demonstrated good antiviral activity, but LPV/r resulted in a significantly greater reduction in plasma HIV-RNA than unboosted ATV (−2.02 vs −1.59 log 10 copies/mL, P , 0.001) at week 48.…”

Section: Atv In Arv-experienced Patientsmentioning

confidence: 99%

Clinical utility and long-term use of atazanavir in the treatment of HIV-1 infection

Rampling¹,

Nelson²

2011

VAAT

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Abstract:The protease inhibitor atazanavir (ATV) now forms an integral component of many combination antiretroviral regimens. It has been shown to have a favorable side effect profile, and it does not negatively affect plasma lipids as some other protease inhibitors can. ATV also has a long half-life, which allows for a once-daily dosing schedule. Coadministration of ATV with low-dose ritonavir (RTV) potentiates the effect of ATV ("RTV boosting"), allowing for lower doses of ATV than those prescribed without RTV. ATV boosted with RTV (ATV/r) has shown noninferiority to RTV-boosted lopinavir (LPV/r), and it has been shown to be effective as a simplification strategy in switch studies. ATV/r-based regimens have also shown promise as a rescue strategy for patients failing other regimens. Several important adverse events and drug interactions have been identified, and care must be taken when administering ATV with other medications. The most commonly reported adverse effect is unconjugated hyperbilirubinemia, which occurs as a result of the metabolic pathway by which it is excreted. Resistance to ATV has been described in both treatment-experienced and treatment-naïve patients.

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“…In the AI424-043 study 58 all patients had failed with at least one PI and were rescued with unboosted ATV versus LPV/r along with a nucleoside backbone selected according to resistance testing. LPV/RTV resulted in a signifi cantly greater reduction in plasma HIV-RNA than unboosted ATV (−2.02 versus −1.59 log 10 copies/mL, p Ͻ 0.001) at week 48.…”

Section: Atazanavir In Switch Studiesmentioning

confidence: 99%

Role of atazanavir in the treatment of HIV infection

Soriano¹

2008

TCRM

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Atazanavir (ATV) is one of the latest protease inhibitors (PI) approved for the treatment of HIV infection. The drug has a relatively long-life (∼7 h) and large inhibitory quotient which allows once daily administration. It is generally well tolerated and the main side effect is hyperbilirubinemia, since ATV inhibits the hepatic uridin-glucoronyl-transferase. A signature mutation at the protease gene, I50L, may confer loss of susceptibility to the drug. Interestingly, it produces hypersusceptibility to all other PIs. When ATV is pharmacokinetically boosted with ritonavir (r) 100 mg/day, a greater genetic barrier for resistance is achieved, and generally more than 3 major PI resistance associated mutations are needed to result in ATV resistance. In drugnaïve subjects, regimens based on ATV/r have shown non-inferiority compared to lopinavir (LPV)/r (CASTLE study) or fosamprenavir/r (ALERT trial), generally with improved tolerance (less diarrhea and dyslipidemia). Given its good tolerance and convenience, ATV has been proven to be successful as a simplifi cation strategy in switch studies (ie, SWAN and SLOAT) conducted in patients with complete virological suppression under other PI-based regimens. Finally, ATV/r-based combinations have shown to be equivalent in terms of viral response to other PI/r-containing regimens, including LPV/r, in rescue interventions in patients failing other PI regimens (ie, studies AI424-045 and NADIS).

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Comparison of atazanavir with lopinavir/ritonavir in patients with prior protease inhibitor failure: a randomized multinational trial

Cited by 85 publications

References 28 publications

Use of HMG-CoA Reductase Inhibitors in the HIV Population: Implications for Individualized Treatment Selection

Use of HMG-CoA Reductase Inhibitors in the HIV Population: Implications for Individualized Treatment Selection

Clinical utility and long-term use of atazanavir in the treatment of HIV-1 infection

Role of atazanavir in the treatment of HIV infection

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