Factors associated with the number of drugs in darunavir/cobicistat regimens
Por:
Martinez, E, Negredo, E, Knobel, H, Ocampo, A, Sanz, J, Garcia-Fraile, L, Martin-Carbonero, L, Lozano, F, Gonzalez-Domenech, C, Gutierrez, M, Montero, M, Boix, V, Payeras, A, Torralba, M, Gonzalez-Cordon, A, Moreno, A, Alejos, B, Perez-Elias, M and GeSIDA 9316 CODAR Study Grp
Publicada:
1 ene 2020
Resumen:
Background: Darunavir/cobicistat can be used as mono, dual, triple or more than triple therapy.
Objectives: To assess factors associated with the number of drugs in darunavir/cobicistat regimens.
Methods: A nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat in Spain from July 2015 to May 2017. Baseline characteristics, efficacy and safety at 48 weeks were compared according to the number of drugs used.
Results: There were 761 patients (75% men, 98% were antiretroviral-experienced, 32% had prior AIDS, 84% had HIV RNA <50 copies/mL and 88% had >= 200 CD4 cells/mm(3)) who initiated darunavir/cobicistat as mono (n=308, 40%), dual (n=173, 23%), triple (n=253, 33%) or four-drug (n=27, 4%) therapy. Relative to monotherapy, triple therapy was more common in men aged <50 years, with prior AIDS and darunavir plus ritonavir use, and with CD4 cells <200/mm(3) and with detectable viral Load at initiation of darunavir/cobicistat; dual therapy was more common with previous intravenous drug use, detectable viral Load at initiation of darunavir/cobicistat and no prior darunavir plus ritonavir; and four-drug therapy was more common with prior AIDS and detectable viral Load at initiation of darunavir/cobicistat. Monotherapy and dual therapy showed a trend to better virological responses than triple therapy. CD4 responses and adverse effects did not differ among regimens.
Discussion: Darunavir/cobicistat use in Spain has been tailored according to clinical characteristics of HIV-infected patients. Monotherapy and dual therapy have been common and preferentially addressed to older patients with a better HIV status, suggesting that health issues other than HIV infection may have been strong determinants of its prescription.
Filiaciones:
Martinez, E:
Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
Negredo, E:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Knobel, H:
Hosp del Mar, Barcelona, Spain
Ocampo, A:
Hosp Alvaro Cunqueiro, Vigo, Spain
Sanz, J:
Hosp Univ Principe Asturias, Alcala De Henares, Spain
Garcia-Fraile, L:
Hosp Univ La Princesa, Madrid, Spain
Martin-Carbonero, L:
Hosp Univ La Paz, Madrid, Spain
Lozano, F:
Hosp Virgen Valme, Seville, Spain
Gonzalez-Domenech, C:
Hosp Univ Virgen Victoria, Malaga, Spain
Gutierrez, M:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Montero, M:
Hosp Univ & Politecn La Fe, Valencia, Spain
:
Hosp Gen Univ Alicante, Alicante, Spain
Payeras, A:
Hosp Sont Llatzer, Palma De Mallorca, Spain
Torralba, M:
Hosp Univ Guadalajara, Guadalajara, Spain
Gonzalez-Cordon, A:
Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
Moreno, A:
Hosp Univ Ramon y Cajal, Madrid, Spain
Alejos, B:
Inst Salud Carlos III, Madrid, Spain
Perez-Elias, M:
Hosp Univ Ramon y Cajal, Madrid, Spain
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