Tolerability of bictegravir/tenofovir alafenamide/emtricitabine versus dolutegravir/lamivudine as maintenance therapy in a real-life setting.
J Antimicrob Chemother
; 78(12): 2961-2967, 2023 12 01.
Article
in En
| MEDLINE
| ID: mdl-37875023
ABSTRACT
BACKGROUND:
While both the burden of therapy and the individual drugs in bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) and dolutegravir/lamivudine differ, it is unclear whether their real-life tolerability may be also different.METHODS:
Single-centre, clinical cohort analysis of all virologically suppressed persons with HIV (PWH) who were first prescribed bictegravir as BIC/TAF/FTC or dolutegravir as dolutegravir/lamivudine and had taken ≥1 dose of study medication. Major outcomes were discontinuations either for any reason or due to toxicity. Incidence was calculated as number of episodes per 100 person-years adjusted through propensity score analysis.RESULTS:
Relative to persons treated with BIC/TAF/FTC (nâ=â1231), persons treated with dolutegravir/lamivudine (nâ=â821) were older and had more AIDS-defining conditions although better HIV control. After a median follow-up of 52 weeks, adjusted incidence rates for discontinuation were 6.68 (95% CI 5.18-8.19) and 8.44 (95% CI 6.29-10.60) episodes per 100 person-years for BIC/TAF/FTC and dolutegravir/lamivudine, respectively; adjusted incidence rate ratio for dolutegravir/lamivudine was 1.26 (95% CI 0.89-1.78) relative to BIC/TAF/FTC (Pâ=â0.1847). Adjusted incidence rates for discontinuation due to toxicity were 3.88 (95% CI 2.70-5.06) and 4.62 (95% CI 3.05-6.19) episodes per 100 person-years for BIC/TAF/FTC and dolutegravir/lamivudine, respectively; adjusted incidence rate ratio for dolutegravir/lamivudine was 1.19 (95% CI 0.75-1.90) relative to BIC/TAF/FTC (Pâ=â0. 4620). Adverse events leading to discontinuation were neuropsychiatric (nâ=â42; 2%), followed by gastrointestinal (nâ=â23; 1%), dermatological (nâ=â15; 1%) and weight increase (nâ=â15; 1%), without differences between regimens.CONCLUSIONS:
Switching to BIC/TAF/FTC or dolutegravir/lamivudine showed no difference in the risks of overall or toxicity-related discontinuations or in the profile of adverse events leading to discontinuation.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Anti-HIV Agents
Limits:
Humans
Language:
En
Journal:
J Antimicrob Chemother
Year:
2023
Document type:
Article
Affiliation country:
Spain