Darunavir Outcomes Study: Comparative Effectiveness of Virologic Suppression, Regimen Durability, and Discontinuation Reasons for Three-Class Experienced Patients at 48 Weeks
- 1 December 2010
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Research and Human Retroviruses
- Vol. 26 (12), 1279-1285
- https://doi.org/10.1089/aid.2010.0059
Abstract
Several new antiretroviral (ARV) agents for treatment experienced HIV-infected patients have been approved since June 2006, including darunavir (DRV) and raltegravir (RAL). While efficacious in clinical trials, the effectiveness, durability, and tolerability of these new ARVs remains understudied in the context of routine clinical care. The Darunavir Outcomes Study is a prospective cohort study of three-class ARV-experienced patients changing regimens at the 1917 Clinic after 1/7/2006. All treatment decisions were at the discretion of primary providers. Multivariate (MV) logistic regression for 48 week VL <400c/ml and Cox models for regimen durability were completed. Propensity score methods controlled for sociodemographics. Among 108 patients, mean age of 46, 48% were white, 80% male, with prior exposure to a mean 10.5 ARVs. Overall, 64% of patients achieved 48-week VL <400 c/ml. In MV modeling DRV/rll (OR = 5.77;95%CI = 1.62–20.58) and RAL (OR = 3.84;95%CI = 1.23–11.95) use increased odds of 48-week suppression. Use of these agents exhibited a trend towards prolonged regimen durability in Cox models. Among those highly ARV-experienced, regimens containing DRV/r and/or RAL were more likely to achieve 48-week VL <400 c/ml and exhibited a trend towards prolonged durability. New agents have transformed the treatment landscape for ARV-experienced patients, with effectiveness in routine clinical care mirroring efficacy in clinical trials.Keywords
This publication has 24 references indexed in Scilit:
- Cost Ramifications of Increased Reporting of Detectable Plasma HIV-1 RNA Levels by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Version 1.0 Viral Load TestJAIDS Journal of Acquired Immune Deficiency Syndromes, 2010
- Comparative Efficacy versus Effectiveness of Initial Antiretroviral Therapy in Clinical Trials versus Routine CareClinical Infectious Diseases, 2010
- Efficacy and safety of darunavir/ritonavir in treatment-experienced HIV type-1 patients in the POWER 1, 2 and 3 trials at week 96Antiviral Therapy, 2009
- Early virologic suppression with three-class experienced patients: 24-week effectiveness in the darunavir outcomes studyAIDS, 2009
- Maraviroc for Previously Treated Patients with R5 HIV-1 InfectionThe New England Journal of Medicine, 2008
- Increased regimen durability in the era of once-daily fixed-dose combination antiretroviral therapyAIDS, 2008
- Raltegravir with Optimized Background Therapy for Resistant HIV-1 InfectionThe New England Journal of Medicine, 2008
- Medication Compliance and Persistence: Terminology and DefinitionsValue in Health, 2008
- The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a reviewInternational Journal of Clinical Practice, 2007
- Duration of Highly Active Antiretroviral Therapy RegimensClinical Infectious Diseases, 2003