多罗替拉韦酯加利匹韦林作为艾滋病病毒感染者转换策略的有效性和耐受性的性别差异。

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES
HIV Medicine Pub Date : 2024-02-20 DOI:10.1111/hiv.13617
Luis Ramos-Ruperto, Maria del Mar Arcos-Rueda, Rosa de Miguel-Buckley, Carmen Busca-Arenzana, Rafael Mican, Rocío Montejano, Ana Delgado-Hierro, María Luisa Montes, María Eulalia Valencia, Lucía Serrano, José Ramon Arribas, Juan González, Jose Ignacio Bernardino, Luz Martín-Carbonero
{"title":"多罗替拉韦酯加利匹韦林作为艾滋病病毒感染者转换策略的有效性和耐受性的性别差异。","authors":"Luis Ramos-Ruperto,&nbsp;Maria del Mar Arcos-Rueda,&nbsp;Rosa de Miguel-Buckley,&nbsp;Carmen Busca-Arenzana,&nbsp;Rafael Mican,&nbsp;Rocío Montejano,&nbsp;Ana Delgado-Hierro,&nbsp;María Luisa Montes,&nbsp;María Eulalia Valencia,&nbsp;Lucía Serrano,&nbsp;José Ramon Arribas,&nbsp;Juan González,&nbsp;Jose Ignacio Bernardino,&nbsp;Luz Martín-Carbonero","doi":"10.1111/hiv.13617","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Dolutegravir + rilpivirine (DTG + RPV) is an effective antiretroviral therapy regimen approved in clinical guidelines as a switch therapy for virologically suppressed people with HIV. Our study aimed to compare the effectiveness and tolerability of DTG + RPV in women and men in real-world clinical practice.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This was a retrospective analysis of treatment-experienced people with HIV from a large HIV unit who switched to DTG + RPV. We analysed treatment effectiveness, rates of adverse events and discontinuation, and metabolic changes after 48 weeks of treatment. HIV-RNA levels &lt;50 copies/mL were analysed at 48 weeks using both intention-to treat analysis (where missing data were interpreted as failures) and per-protocol analysis (excluding those with missing data or changes due to reasons other than virological failure). Outcomes were compared between women and men based on sex at birth.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 307 patients were selected (71 women and 236 men). No transgender people were included. At baseline, women had lived with HIV infection and received antiretroviral therapy for longer than men (23.2 vs 17.4 years and 18.9 vs 14.2 years, respectively). In the intention-to-treat analysis, 74.6% (95% confidence interval [CI] 63.4–83.3%) of women and 83.5% (95% CI 78.2–87.7) of men had HIV-RNA &lt;50 copies/mL. In the per-protocol analysis, 96.4% (95% CI 87.7–99) of women and 99% (95% CI 98.9–99.7) of men had HIV-RNA levels &lt;50 copies/mL. Two women and two men had HIV-RNA &gt;50 copies/mL at 48 weeks. Discontinuation due to adverse events was more frequent in women than in men: 12.7% vs 7.2% (<i>p</i> &lt; 0.02). Neuropsychiatric and gastrointestinal events were the most frequently reported. A median (interquartile range) weight gain of 1.9 kg (0–4.2) in women and 1.2 kg (−1–3.1) in men was reported (median of differences between baseline visit and week 48); the remaining changes in metabolic parameters were neutral.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>DTG + RPV exhibited good and similar virological effectiveness in women and men in real-world settings. However, poorer tolerability and more treatment interruptions were observed in women.</p>\n </section>\n </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sex differences in the effectiveness and tolerability of dolutegravir plus rilpivirine as a switch strategy in people living with HIV\",\"authors\":\"Luis Ramos-Ruperto,&nbsp;Maria del Mar Arcos-Rueda,&nbsp;Rosa de Miguel-Buckley,&nbsp;Carmen Busca-Arenzana,&nbsp;Rafael Mican,&nbsp;Rocío Montejano,&nbsp;Ana Delgado-Hierro,&nbsp;María Luisa Montes,&nbsp;María Eulalia Valencia,&nbsp;Lucía Serrano,&nbsp;José Ramon Arribas,&nbsp;Juan González,&nbsp;Jose Ignacio Bernardino,&nbsp;Luz Martín-Carbonero\",\"doi\":\"10.1111/hiv.13617\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Dolutegravir + rilpivirine (DTG + RPV) is an effective antiretroviral therapy regimen approved in clinical guidelines as a switch therapy for virologically suppressed people with HIV. Our study aimed to compare the effectiveness and tolerability of DTG + RPV in women and men in real-world clinical practice.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This was a retrospective analysis of treatment-experienced people with HIV from a large HIV unit who switched to DTG + RPV. We analysed treatment effectiveness, rates of adverse events and discontinuation, and metabolic changes after 48 weeks of treatment. HIV-RNA levels &lt;50 copies/mL were analysed at 48 weeks using both intention-to treat analysis (where missing data were interpreted as failures) and per-protocol analysis (excluding those with missing data or changes due to reasons other than virological failure). Outcomes were compared between women and men based on sex at birth.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 307 patients were selected (71 women and 236 men). No transgender people were included. At baseline, women had lived with HIV infection and received antiretroviral therapy for longer than men (23.2 vs 17.4 years and 18.9 vs 14.2 years, respectively). In the intention-to-treat analysis, 74.6% (95% confidence interval [CI] 63.4–83.3%) of women and 83.5% (95% CI 78.2–87.7) of men had HIV-RNA &lt;50 copies/mL. In the per-protocol analysis, 96.4% (95% CI 87.7–99) of women and 99% (95% CI 98.9–99.7) of men had HIV-RNA levels &lt;50 copies/mL. Two women and two men had HIV-RNA &gt;50 copies/mL at 48 weeks. Discontinuation due to adverse events was more frequent in women than in men: 12.7% vs 7.2% (<i>p</i> &lt; 0.02). Neuropsychiatric and gastrointestinal events were the most frequently reported. A median (interquartile range) weight gain of 1.9 kg (0–4.2) in women and 1.2 kg (−1–3.1) in men was reported (median of differences between baseline visit and week 48); the remaining changes in metabolic parameters were neutral.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>DTG + RPV exhibited good and similar virological effectiveness in women and men in real-world settings. However, poorer tolerability and more treatment interruptions were observed in women.</p>\\n </section>\\n </div>\",\"PeriodicalId\":13176,\"journal\":{\"name\":\"HIV Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"HIV Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/hiv.13617\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hiv.13617","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

摘要

简介多托曲韦+利匹韦林(DTG+RPV)是一种有效的抗逆转录病毒治疗方案,已被临床指南批准作为病毒学抑制的艾滋病病毒感染者的转换疗法。我们的研究旨在比较 DTG + RPV 在实际临床实践中对女性和男性的有效性和耐受性:这是一项回顾性分析,研究对象是一家大型艾滋病治疗机构中转用 DTG + RPV 的有治疗经验的艾滋病病毒感染者。我们分析了治疗效果、不良事件发生率和停药率,以及治疗 48 周后的代谢变化。HIV-RNA 水平 结果:共选取了 307 名患者(71 名女性和 236 名男性)。其中不包括变性人。基线时,女性感染 HIV 和接受抗逆转录病毒治疗的时间比男性长(分别为 23.2 年对 17.4 年和 18.9 年对 14.2 年)。在意向治疗分析中,74.6%(95% 置信区间 [CI] 63.4-83.3%)的女性和 83.5%(95% CI 78.2-87.7)的男性在 48 周时 HIV-RNA 为 50 copies/mL。女性因不良反应而停药的比例高于男性:12.7% 对 7.2%(P 结论:DTG + RPV 在女性和男性中均有良好的疗效:在实际环境中,DTG + RPV 对女性和男性的病毒学疗效良好且相似。然而,女性的耐受性较差,中断治疗的情况较多。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sex differences in the effectiveness and tolerability of dolutegravir plus rilpivirine as a switch strategy in people living with HIV

Introduction

Dolutegravir + rilpivirine (DTG + RPV) is an effective antiretroviral therapy regimen approved in clinical guidelines as a switch therapy for virologically suppressed people with HIV. Our study aimed to compare the effectiveness and tolerability of DTG + RPV in women and men in real-world clinical practice.

Methods

This was a retrospective analysis of treatment-experienced people with HIV from a large HIV unit who switched to DTG + RPV. We analysed treatment effectiveness, rates of adverse events and discontinuation, and metabolic changes after 48 weeks of treatment. HIV-RNA levels <50 copies/mL were analysed at 48 weeks using both intention-to treat analysis (where missing data were interpreted as failures) and per-protocol analysis (excluding those with missing data or changes due to reasons other than virological failure). Outcomes were compared between women and men based on sex at birth.

Results

A total of 307 patients were selected (71 women and 236 men). No transgender people were included. At baseline, women had lived with HIV infection and received antiretroviral therapy for longer than men (23.2 vs 17.4 years and 18.9 vs 14.2 years, respectively). In the intention-to-treat analysis, 74.6% (95% confidence interval [CI] 63.4–83.3%) of women and 83.5% (95% CI 78.2–87.7) of men had HIV-RNA <50 copies/mL. In the per-protocol analysis, 96.4% (95% CI 87.7–99) of women and 99% (95% CI 98.9–99.7) of men had HIV-RNA levels <50 copies/mL. Two women and two men had HIV-RNA >50 copies/mL at 48 weeks. Discontinuation due to adverse events was more frequent in women than in men: 12.7% vs 7.2% (p < 0.02). Neuropsychiatric and gastrointestinal events were the most frequently reported. A median (interquartile range) weight gain of 1.9 kg (0–4.2) in women and 1.2 kg (−1–3.1) in men was reported (median of differences between baseline visit and week 48); the remaining changes in metabolic parameters were neutral.

Conclusions

DTG + RPV exhibited good and similar virological effectiveness in women and men in real-world settings. However, poorer tolerability and more treatment interruptions were observed in women.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信