2-Drug Regimen Tested for HIV
Dolutegravir-rilpivirine was safe and non-inferior to current antiretroviral therapy (ART) over 48 weeks in adults with HIV suppression, according to the results of a recent study.
Two-drug regimens for ART are of interest, in order to minimize drug exposure and toxicity. The efficacy, safety, and tolerability of dolutegravir and rilpivirine suggest that they may be good candidates for a 2-drug regimen.
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For their study, the researchers conducted 2 open-label, parallel-group, multicenter, phase 3, randomized, non-inferiority studies that evaluated the efficacy and safety of once-daily dolutegravir 50 mg plus rilpivirine 25 mg vs current ART regimen. Participants were on their first or second ART with stable plasma HIV-1 RNA for 6 months or longer at screening.
The researchers assigned 516 participants to dolutegravir 50 mg plus rilpivirine 25 mg and 512 to continue with current ART. At week 48, 95% of participants had viral loads lower than 50 copies per mL in both groups, with an adjusted treatment difference of -0.2%. Further, 395 participants in the dolutegravir 50 mg plus rilpivirine 25 mg group and 364 of those in the ART group reported adverse effects.
“Dolutegravir-rilpivirine was non-inferior to CAR over 48 weeks in participants with HIV suppression and showed a safety profile consistent with its components. Results support the use of this two-drug regimen to maintain HIV suppression.”
—Michael Potts
Reference:
Llibre JM, Hung C, Brinson C, et al. Efficacy, safety, and tolerability of dolutegravir-rilpivirine for the maintenance of virological suppression in adults with HIV-1: phase 3, randomised, non-inferiority SWORD-1 and SWORD-2 studies [published online January 5, 2018]. Lancet. DOI: http://dx.doi.org/10.1016/S0140-6736(17)33095-7.
