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Dolutegravir Dual Therapy as Maintenance Treatment in HIV-Infected Patients: A Review

Dolutegravir Dual Therapy as Maintenance Treatment in HIV-Infected Patients: A Review Objective: To review available evidence for dolutegravir-based dual therapy as maintenance treatment in HIV-1 infected patients. Data Sources: A literature search was conducted using PubMed, MEDLINE, and Google Scholar to the end of January 2018. Conference abstracts and article bibliographies were also reviewed. Study Selection and Data Extraction: All English-language, randomized, and observational studies were included. Data Synthesis: In all, 12 studies were identified: 10 were observational, and 2 were randomized trials. Rilpivirine or lamivudine were the most common second agent used in combination with dolutegravir. Virological suppression seen in observational studies appear promising; however, the most compelling evidence to date is the 48-week results from 2 large open-label randomized trials (SWORD 1 and 2). These studies found that dual therapy with rilpivirine and dolutegravir was noninferior to 3- or 4-drug combination antiretroviral therapy (cART). The long-term efficacy, safety, and tolerability of dual therapy, as compared with usual cART, are less clear and require further data. Conclusions: Regimen switching in virally suppressed HIV-1–infected patients may be considered to reduce pill burden or dosing frequency, decrease short- or long-term toxicity, prevent or manage drug-drug interactions, and/or decrease cost. Based on available evidence, a switch to dual therapy with dolutegravir and rilpivirine appears viable for virologically suppressed patients without prior resistance mutations to these agents. Randomized studies of other dual-therapy regimens that include dolutegravir and longer-term follow-up as well as cost-effectiveness analyses are needed to provide confirmation that this strategy offers advantages to traditional cART regimens. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Pharmacotherapy SAGE

Dolutegravir Dual Therapy as Maintenance Treatment in HIV-Infected Patients: A Review

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References (11)

Publisher
SAGE
Copyright
© The Author(s) 2018
ISSN
1060-0280
eISSN
1542-6270
DOI
10.1177/1060028018758432
Publisher site
See Article on Publisher Site

Abstract

Objective: To review available evidence for dolutegravir-based dual therapy as maintenance treatment in HIV-1 infected patients. Data Sources: A literature search was conducted using PubMed, MEDLINE, and Google Scholar to the end of January 2018. Conference abstracts and article bibliographies were also reviewed. Study Selection and Data Extraction: All English-language, randomized, and observational studies were included. Data Synthesis: In all, 12 studies were identified: 10 were observational, and 2 were randomized trials. Rilpivirine or lamivudine were the most common second agent used in combination with dolutegravir. Virological suppression seen in observational studies appear promising; however, the most compelling evidence to date is the 48-week results from 2 large open-label randomized trials (SWORD 1 and 2). These studies found that dual therapy with rilpivirine and dolutegravir was noninferior to 3- or 4-drug combination antiretroviral therapy (cART). The long-term efficacy, safety, and tolerability of dual therapy, as compared with usual cART, are less clear and require further data. Conclusions: Regimen switching in virally suppressed HIV-1–infected patients may be considered to reduce pill burden or dosing frequency, decrease short- or long-term toxicity, prevent or manage drug-drug interactions, and/or decrease cost. Based on available evidence, a switch to dual therapy with dolutegravir and rilpivirine appears viable for virologically suppressed patients without prior resistance mutations to these agents. Randomized studies of other dual-therapy regimens that include dolutegravir and longer-term follow-up as well as cost-effectiveness analyses are needed to provide confirmation that this strategy offers advantages to traditional cART regimens.

Journal

Annals of PharmacotherapySAGE

Published: Jul 1, 2018

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