Univ Brescia, Brescia, Italy.
HIV Clin Trials. 2009 Nov-Dec;10(6):356-67. doi: 10.1310/hct1006-356.
Fosamprenavir/ritonavir 1400 mg/100 mg once-daily regimen may have a more favourable tolerability and lipid profile than the fosamprenavir/ritonavir twice-daily regimen, while maintaining comparable antiviral efficacy.
This open-label study had a group-sequential design with a stage 1 Week 24 futility analysis, with both efficacy and safety go-criteria for progression to stage 2. There were 214 antiretroviral-naive, HIV-1-infected subjects who were randomised to receive either fosamprenavir/ritonavir 1400 mg/100 mg once daily or fosamprenavir/ ritonavir 700 mg/100 mg twice daily, both with abacavir/lamivudine fixed-dose combination tablet. Primary endpoints were the proportion of subjects achieving HIV-1 RNA <400 copies/mL at Week 48 and the mean change from baseline in fasting non-HDL cholesterol.
Though stage 1 futility analysis did not meet criteria for progression to stage 2, subjects enrolled in stage 1 were followed to Week 48 per protocol. At Week 48, noninferior efficacy of once daily to twice daily (95% CI around the treatment difference, -11.4 to 9.5) was achieved, with 86/106 (81%) subjects in the once-daily and 87/106 (82%) in the twice-daily arm achieving HIV-1 RNA <400 copies/mL. Mean change from baseline at Week 48 in non-HDL cholesterol was 1.10 mmol/L and 1.26 mmol/L (p = .478) for the once-daily and twice-daily arms, respectively.
Though the study did not continue to stage 2, fosamprenavir/ritonavir once daily demonstrated noninferior antiviral efficacy to fosamprenavir/ritonavir twice daily.
与福沙那韦/利托那韦每日两次给药方案相比,福沙那韦/利托那韦1400毫克/100毫克每日一次给药方案可能具有更好的耐受性和血脂谱,同时保持相当的抗病毒疗效。
这项开放标签研究采用组序设计,进行第1阶段第24周的无效性分析,进入第2阶段有疗效和安全性的准入标准。共有214名未接受过抗逆转录病毒治疗的HIV-1感染受试者,随机分为接受福沙那韦/利托那韦1400毫克/100毫克每日一次或福沙那韦/利托那韦700毫克/100毫克每日两次给药,均联合阿巴卡韦/拉米夫定固定剂量复方片剂。主要终点为第48周时HIV-1 RNA<400拷贝/毫升的受试者比例以及空腹非高密度脂蛋白胆固醇相对于基线的平均变化。
尽管第1阶段的无效性分析未达到进入第2阶段的标准,但按照方案对第1阶段入组的受试者随访至第48周。在第48周时,每日一次给药方案的疗效不劣于每日两次给药方案(治疗差异的95%置信区间为-11.4至9.5),每日一次给药组中86/106(81%)的受试者以及每日两次给药组中87/106(82%)的受试者HIV-1 RNA<400拷贝/毫升。第48周时,每日一次给药组和每日两次给药组空腹非高密度脂蛋白胆固醇相对于基线的平均变化分别为1.10毫摩尔/升和1.26毫摩尔/升(p = 0.478)。
尽管该研究未进入第2阶段,但福沙那韦/利托那韦每日一次给药方案显示出与福沙那韦/利托那韦每日两次给药方案相当的抗病毒疗效。