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在一项为期48周的3期试验中,用考比司他增强的达芦那韦治疗老年HIV-1感染受试者。

Treating Older HIV-1-infected Subjects With Cobicistat-boosted Darunavir in a 48-week Phase 3 Trial.

作者信息

Brown Kimberley, Patterson-Browning Brooke, Liu Chris, Patel Meera, Stewart Lisa, Nettles Richard E

机构信息

Janssen Scientific Affairs, LLC, Titusville, NJ, USA.

Janssen Research & Development, LLC, Titusville, NJ, USA.

出版信息

Rev Recent Clin Trials. 2017;12(3):174-181. doi: 10.2174/1574887112666170407171106.

DOI:10.2174/1574887112666170407171106
PMID:28403798
Abstract

BACKGROUND

An aging HIV-1-infected population warrants examination of the acceptability of individual antiretroviral regimens. In a previous study of ritonavir-boosted darunavir (ARTEMIS), similar safety/efficacy profiles were observed in younger (≤45 years) and older (>45 years) HIV-1-infected subjects.

OBJECTIVE

To evaluate safety and efficacy outcomes in HIV-1-infected younger versus older subjects treated with cobicistat-boosted darunavir.

METHOD

In a 48-week, phase 3b, open-label trial, HIV-1-infected adults were administered darunavir 800 mg and cobicistat 150 mg once-daily with 2 nucleos(t)ide reverse transcriptase inhibitors (N[t]RTIs). Post hoc analyses examined safety and efficacy outcomes in subjects ≤45 and >45 years.

RESULTS

Of 313 subjects, 76% were ≤45 years (median [range] age, 31 [18-45]) and 24% were >45 years (49 [46-72]). Baseline median (range) viral loads were 4.75 (2.6-6.8) and 4.83 (2.7-7.0) log10 copies/mL, and CD4+ counts were 379.0 (5-1473) and 310.5 (6-757) cells/mm3 in younger and older subjects, respectively. Through Week 48, similar proportions of younger and older subjects had ≥1 adverse event (AE; 93% vs 88%), ≥1 grade 2-4 AE possibly related to study drug (13% vs 15%), and discontinued study due to AE (3% vs 3%). At Week 48, 82% of younger and 78% of older subjects had viral load <50 copies/mL (95% CI of the difference: -7.4% to 13.8%). A higher proportion of older versus younger subjects took >4 concomitant medications during the study (69% vs 57%).

CONCLUSION

Safety and efficacy profiles of cobicistat-boosted darunavir with 2 N(t)RTIs were similar in HIV-1-infected subjects ≤45 and >45 years.

摘要

背景

感染人类免疫缺陷病毒1型(HIV-1)的人群老龄化,这使得有必要对个体化抗逆转录病毒治疗方案的可接受性进行研究。在先前一项关于利托那韦增强达芦那韦的研究(ARTEMIS)中,在年龄较小(≤45岁)和年龄较大(>45岁)的HIV-1感染受试者中观察到了相似的安全性/疗效概况。

目的

评估接受考比司他增强达芦那韦治疗的HIV-1感染的年轻与年长受试者的安全性和疗效结果。

方法

在一项为期48周的3b期开放标签试验中,给HIV-1感染的成年人每日一次服用800mg达芦那韦和150mg考比司他,并联合两种核苷(酸)逆转录酶抑制剂(N[t]RTIs)。事后分析检查了年龄≤45岁和>45岁受试者的安全性和疗效结果。

结果

在313名受试者中,76%年龄≤45岁(中位[范围]年龄,31[18 - 45]岁),24%年龄>45岁(49[46 - 72]岁)。年轻和年长受试者的基线中位(范围)病毒载量分别为4.75(2.6 - 6.8)和4.83(2.7 - 7.0)log10拷贝/mL,CD4 +细胞计数分别为379.0(5 - 1473)和310.5(6 - 757)个细胞/mm³。至第48周时,年轻和年长受试者中发生≥1次不良事件(AE)的比例相似(93%对88%),发生≥1次可能与研究药物相关的2 - 4级AE的比例相似(13%对15%),因AE而停药的比例相似(3%对3%)。在第48周时,82%的年轻受试者和78%的年长受试者病毒载量<50拷贝/mL(差异的95%CI:-7.4%至13.8%)。在研究期间,年长受试者服用>4种伴随药物的比例高于年轻受试者(69%对57%)。

结论

考比司他增强达芦那韦联合两种N(t)RTIs在年龄≤45岁和>45岁的HIV-1感染受试者中的安全性和疗效概况相似。

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