학술논문
Raltegravir 1200 mg once daily as maintenance therapy in virologically suppressed HIV-1 infected adults: QDISS open-label trial.
Document Type
Article
Author
Hall, Nolwenn; Allavena, Clotilde; Katlama, Christine; Jobert, Alexandra; Molina, Jean-Michel; Cua, Eric; Bani-Sadr, Firouzé; Hocqueloux, Laurent; Duvivier, Claudine; Merrien, Dominique; Hikombo, Hitoto; André-Garnier, Elisabeth; Gaultier, Aurélie; Raffi, François; the QDISS Study Group; Bollengier, Olivier; Guimard, Thomas; Leautez, Sophie; Blanchi, Sophie; Becker, Agathe
Source
Subject
*HIV infections
*RALTEGRAVIR
*DRUG efficacy
*RESEARCH
*HIV-positive persons
*LIFESTYLES
*COMBINATION drug therapy
*CLINICAL trials
*CONFIDENCE intervals
*GENETIC mutation
*ANTIRETROVIRAL agents
*MEDICAL cooperation
*LDL cholesterol
*HEALTH outcome assessment
*DESCRIPTIVE statistics
*QUALITY of life
*BODY mass index
*ALGORITHMS
*EVALUATION
*ADULTS
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Language
ISSN
1742-6405
Abstract
Background: Raltegravir (RAL) has favorable tolerability and safety profile, with few and manageable drug interactions. The use of RAL 1200 mg once daily (qd) for first-line therapy is well established. We assessed efficacy and safety of RAL 1200 mg qd, as part of triple combined antiretroviral therapy (cART), for maintenance strategy. Methods: The QDISS trial (NCT03195452) was a 48-week multicenter, single-arm, open-label study designed to evaluate the ability of 2 NRTIs + RAL 1200 mg qd to maintain virological suppression in HIV-1 infected subjects on a stable cART with 2 NRTIs and a third agent for at least 6 months. The primary endpoint was the proportion of participants with HIV-1 RNA < 50 copies/mL at week 24, by the FDA snapshot algorithm. Results: Of 100 participants 91% maintained viral suppression (95% CI: 83.6–95.8) at week 24 and 89% (81.2–94.4) at week 48. At week 24, there was one virological failure, without emergence of resistance-associated mutation and 10 participants had discontinued, 4 because of adverse events (AEs). Over 48 weeks, 7 AEs of grade 3–4 were reported, one possibly study-drug related (spontaneous abortion). BMI remained stable regardless of previous therapy or baseline BMI category. Over 48 weeks, total cholesterol (p = 0.023) and LDL-cholesterol (p = 0.009) decreased, lifestyle and ease subscale significantly improved (p = 0.04). The quality of life and Patients Reported Outcomes (PROs) also improved at W12 (p = 0.007). Conclusion: RAL 1200 mg qd as part of a maintenance triple therapy showed a high efficacy in virologically suppressed HIV-1 infected subjects, with good safety profile and improved lipid profile and patient reported outcomes. Trial registration: Clinical trials.gov NCT03195452 and EudraCT 2016-003702-13. [ABSTRACT FROM AUTHOR]