Raltegravir, maraviroc, etravirine: an effective protease inhibitor and nucleoside reverse transcriptase inhibitor-sparing regimen for salvage therapy in HIV-infected patients with triple-class experience

Abstract

We prospectively evaluated 28 triple-class experienced HIV-1-infected patients harbouring R5 virus, who received maraviroc, raltegravir and etravirine. By on-treatment analysis, 26 (92%) had less than 50 copies HIV-RNA/ml at week 48. The median (interquartile range) 48-week increase in CD4 cell counts was 267 (136-355) cells/microl. Three serious adverse events occurred: one recurrence of mycobacterial spondylodiscitis, one anal cancer, one Hodgkin lymphoma. Although long-term safety needs further study, this protease inhibitor and nucleoside analogue-sparing regimen showed sustained efficacy.

Short Communication: High Effectiveness of Etravirine in Routine Clinical Practice in Treatment-Experienced HIV Type 1-Infected Patients

“…In addition, viral suppression has also been observed in 92% of patients in a setting with more limited therapeutic options, namely, a PI and NRTI-sparing regimen containing ETR plus maraviroc and raltegravir. 11 In our series, the number of patients taking maraviroc or other boosted PIs (not darunavir) plus ETR was too low for conclusions to be drawn about efficacy.…”

“…2,3 The safety and efficacy of ETR in combination with the remaining new antiretrovirals have not been evaluated outside the strictly controlled conditions of a clinical trial, although preliminary reports on the combination of these new drugs have shown promising results. [9][10][11][12] We evaluated the effectiveness of rescue regimens containing ETR combined with all the available active agents in routine clinical practice. We also analyzed the relationship between the 1 Lluita contra la SIDA, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona number of additional active drugs in the optimized regimen and other factors associated with the response to ETR.…”

CCR5 Antagonist TD-0680 Uses a Novel Mechanism for Enhanced Potency against HIV-1 Entry, Cell-mediated Infection, and a Resistant Variant

“…TD-0680 can be a salvage choice for patients who have developed a competitive resistant virus like HIV-1 BaL -c5.6r (46,47). Although rare, treatment failure has been documented due to Maraviroc-resistant R5-tropic-remaining viruses detected in Maraviroc-treated patients (45).…”

Safety, efficacy and indications of prescription of maraviroc in clinical practice: Factors associated with clinical outcomes

“…It prevents the interaction of the external membrane glycoprotein, gp120, with the host cell receptor (Fatkenheuer et al, 2005;Dorr et al, 2005). Strand-transfer integrase inhibitors, etravirine or darunavir were not employed in maraviroc registrational trials but have been used with it afterwards when available in the clinic (Nozza et al, 2010). Maraviroc was compared with efavirenz in initial antiretroviral treatment (ART) , both with coformulated zidovudine-lamivudine, a combination no longer recommended http://dx.…”

“…NRTIs were not included in one third of our patients, mainly due to widespread NRTI resistance. Rarely (3.5%), some subjects received NRTI-and PI-sparing regimens, a regimen associated with sustained efficacy in a pilot study in highly selected subjects (Nozza et al, 2010).…”