Use of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce. We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test. Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available (P = .008 and .01, respectively). Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.

Mazzitelli, M., Degli Antoni, M., Castelli, F., Ripamonti, D., Zuglian, G., Lapadula, G., et al. (2022). Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study. MEDICINE, 101(30) [10.1097/MD.0000000000029855].

Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study

Lapadula, G;
2022

Abstract

Use of doravirine (DOR), a new nonnucleoside reverse-transcriptase inhibitors recently approved for HIV treatment, is still unclear in clinical practice and real-life data are scarce. We retrospectively investigated the rationale for switching people with HIV to DOR-containing/-based regimens in a real-life cohort. Among 132 patients (68.9% males, median age 56 years), the main reasons to start DOR were prevention of toxicities (39.4%) and dyslipidemia (18.2%). DOR was combined with integrase inhibitors in 40.9% cases, and in 25.7% of patients, DOR was prescribed without availability of a genotypic resistance test. Twenty-four weeks after the switch to DOR-containing/-based regimens, no significant changes in CD4+ T-cell count, CD4/CD8 ratio, detectable HIV-RNA, serum creatinine levels, and body weight were detected. By contrast, a significant reduction in lipids (both cholesterol and triglycerides) was observed in 52 patients for whom a follow-up assessment was available (P = .008 and .01, respectively). Our data confirmed that switching to DOR-containing/-based regimens may have a favorable impact on lipid profile and a neutral impact on weight gain. However, more data are needed to support its use in patients who do not have a genotypic test available or have an extensive nonnucleoside reverse-transcriptase inhibitors-associated resistance, as well as its use in a dual regimen, especially in combination with second-generation integrase inhibitors.
Articolo in rivista - Articolo scientifico
doravirine; dyslipidemia; HIV; PLWH; real-life; switch; DNA-Directed RNA Polymerases; Female; Humans; Integrase Inhibitors; Male; Middle Aged; Pyridones; Retrospective Studies; Reverse Transcriptase Inhibitors; Triazoles; Anti-HIV Agents; HIV Infections
English
2022
101
30
29855
none
Mazzitelli, M., Degli Antoni, M., Castelli, F., Ripamonti, D., Zuglian, G., Lapadula, G., et al. (2022). Real-life use of Doravirine in treatment-experienced people living with HIV: A multicenter Italian study. MEDICINE, 101(30) [10.1097/MD.0000000000029855].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/393492
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