Your browser doesn't support javascript.
loading
Comparison of the metabolic effects of ritonavir-boosted darunavir or atazanavir versus raltegravir, and the impact of ritonavir plasma exposure: ACTG 5257.
Ofotokun, Ighovwerha; Na, Lumine H; Landovitz, Raphael J; Ribaudo, Heather J; McComsey, Grace A; Godfrey, Catherine; Aweeka, Francesca; Cohn, Susan E; Sagar, Manish; Kuritzkes, Daniel R; Brown, Todd T; Patterson, Kristine B; Para, Michael F; Leavitt, Randi Y; Villasis-Keever, Angelina; Baugh, Bryan P; Lennox, Jeffrey L; Currier, Judith S.
Afiliação
  • Ofotokun I; Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia.
  • Na LH; Harvard School of Public Health, Boston, Massachusetts.
  • Landovitz RJ; Division of Infectious Diseases, Center for Clinical AIDS Research and Education, University of California, Los Angeles.
  • Ribaudo HJ; Harvard School of Public Health, Boston, Massachusetts.
  • McComsey GA; Case Western Reserve University, Cleveland, Ohio.
  • Godfrey C; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
  • Aweeka F; University of California, San Francisco School of Pharmacy.
  • Cohn SE; Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • Sagar M; School of Medicine, Boston University.
  • Kuritzkes DR; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  • Brown TT; Johns Hopkins University, Baltimore, Maryland.
  • Patterson KB; University of North Carolina School of Medicine, Chapel Hill.
  • Para MF; The Ohio State University College of Medicine, Columbus.
  • Leavitt RY; Merck & Co, Inc, Whitehouse Station, New Jersey.
  • Villasis-Keever A; Bristol-Myers Squibb, New York, New York.
  • Baugh BP; Janssen Scientific Affairs, LLC, Titusville, New Jersey.
  • Lennox JL; Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia.
  • Currier JS; Division of Infectious Diseases, Center for Clinical AIDS Research and Education, University of California, Los Angeles.
Clin Infect Dis ; 60(12): 1842-51, 2015 06 15.
Article em En | MEDLINE | ID: mdl-25767256
BACKGROUND: Metabolic effects following combination antiretroviral therapy (cART) vary by regimen type. Changes in metabolic effects were assessed following cART in the AIDS Clinical Trials Group (ACTG) A5257 study, and correlated with plasma ritonavir trough concentrations (C24). METHODS: Treatment-naive adult subjects were randomized to ritonavir-boosted atazanavir or darunavir, or raltegravir-based cART. Changes in lipids and other metabolic outcomes over time were estimated. Differences between arms were estimated with 97.5% confidence intervals and compared using pairwise Student t tests. Associations between ritonavir C24 and lipid changes at week 48 were evaluated via linear regression. RESULTS: Analyses included 1797 subjects with baseline fasting data. Baseline lipid profiles and metabolic syndrome rates (approximately 21%) were similar across arms. Comparable increases occurred in total cholesterol, triglycerides, and low-density lipoprotein cholesterol with the boosted protease inhibitors (PIs); each PI had greater increases relative to raltegravir (all P ≤ .001 at week 96). Metabolic syndrome incident rates by week 96 (approximately 22%) were not different across arms. Ritonavir C24 was not different by arm (P = .89) (median, 69 ng/mL and 74 ng/mL in the atazanavir and darunavir arms, respectively) and were not associated with changes in lipid measures (all P > .1). CONCLUSIONS: Raltegravir produced the most favorable lipid profile. Metabolic syndrome rates were high at baseline and increased to the same degree in all arms. Ritonavir C24 was not different in the PI arms and had no relationship with the modest but comparable increases in lipids observed with either atazanavir or darunavir. The long-term clinical significance of the lipid changes noted with the PIs relative to raltegravir deserves further evaluation. CLINICAL TRIALS REGISTRATION: NCT 00811954.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 / Ritonavir / Fármacos Anti-HIV / Darunavir / Sulfato de Atazanavir / Raltegravir Potássico Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 / Ritonavir / Fármacos Anti-HIV / Darunavir / Sulfato de Atazanavir / Raltegravir Potássico Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article