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阿巴卡韦/多替拉韦/拉米夫定用于HIV-1患者的韩国上市后研究。

A Korean Post-Marketing Study of Abacavir/Dolutegravir/Lamivudine in Patients with HIV-1.

作者信息

Shin Sang-Kyu, Cho Jung-Eun, Lee Eun-Bin, Kim Yeon-Sook, Jung Sook-In

机构信息

GlaxoSmithKline Korea, Seoul, Korea.

Division of Infectious Diseases, Chungnam National University School of Medicine, Daejeon, Korea.

出版信息

Infect Chemother. 2023 Sep;55(3):337-345. doi: 10.3947/ic.2022.0176. Epub 2023 May 4.

Abstract

BACKGROUND

Abacavir/dolutegravir/lamivudine has been indicated in Korea since 2015 for treatment of human immunodeficiency virus type 1 (HIV-1) infection in combination. This regulatory post-marketing surveillance (PMS) study evaluated the real-life safety and effectiveness of abacavir/dolutegravir/lamivudine in patients with HIV-1 in clinical practice in Korea.

MATERIALS AND METHODS

This open-label post-marketing surveillance examined data from consecutive patients (aged ≥12 years) with HIV-1 infection receiving abacavir/dolutegravir/lamivudine according to locally approved prescribing information; treatment-naïve and treatment-experienced patients were permitted. Data regarding patient demographics, medical history, clinical characteristics, medications (HIV-1 related and concomitant), resource utilization and comorbidities were extracted from patient records over a 1-year treatment period. Outcomes included safety of abacavir/dolutegravir/lamivudine (primary endpoint) and real-life effectiveness according to physician's global assessment and the proportion of patients with plasma HIV-1 RNA count <50 copies/mL at 48 weeks.

RESULTS

Of 663 patients treated with abacavir/dolutegravir/lamivudine at 27 centers in Korea (June 2015 - June 2021), 656 were eligible for the safety analyses and 484 for effectiveness analyses. Patients were mostly male (94.8%) mean age was 42.2 ± 14.0 years and mean weight was 68.1 ± 11.0 kg. Adverse events (AEs, n = 656 in total) were mostly mild in severity, with the most common being nasopharyngitis (7.9%), retching (7.5%), headache (4.9%). Of 121 adverse drug reactions (ADRs), the most frequent were retching (4.4%), headache (1.8%) and dizziness (1.7%). Of 55 serious AEs, the most frequent were anogenital warts (1.1%). Of 2 serious ADRs, nothing was unexpected, and both resolved. The risk of experiencing an AE while receiving abacavir/dolutegravir/lamivudine appeared to be especially increased in patients receiving concomitant medications for other conditions. Abacavir/dolutegravir/lamivudine effectively suppressed HIV-1 (96.1% of patients had plasma HIV-1 RNA <50 copies/mL), and 99.0% of patients showed symptom improvement based on physician assessment.

CONCLUSION

Results of this PMS study showed that abacavir/dolutegravir/lamivudine administered as highly active antiretroviral therapy was well tolerated and effective in patients with HIV-1 infection.

摘要

背景

自2015年起,阿巴卡韦/多替拉韦/拉米夫定在韩国被批准用于联合治疗1型人类免疫缺陷病毒(HIV-1)感染。这项监管性上市后监测(PMS)研究评估了阿巴卡韦/多替拉韦/拉米夫定在韩国临床实践中HIV-1患者中的实际安全性和有效性。

材料与方法

这项开放标签的上市后监测研究检查了连续接受阿巴卡韦/多替拉韦/拉米夫定治疗的HIV-1感染患者(年龄≥12岁)的数据,这些数据符合当地批准的处方信息;初治和经治患者均可纳入。在1年的治疗期内,从患者记录中提取有关患者人口统计学、病史、临床特征、药物(与HIV-1相关及合并用药)、资源利用和合并症的数据。观察指标包括阿巴卡韦/多替拉韦/拉米夫定的安全性(主要终点)以及根据医生整体评估得出的实际有效性和48周时血浆HIV-1 RNA计数<50拷贝/mL的患者比例。

结果

在韩国27个中心接受阿巴卡韦/多替拉韦/拉米夫定治疗的663例患者中(2015年6月至2021年6月),656例符合安全性分析标准,484例符合有效性分析标准。患者大多为男性(94.8%),平均年龄为42.2±14.0岁,平均体重为68.1±11.0 kg。不良事件(AEs,共656例)大多为轻度,最常见的是鼻咽炎(7.9%)、干呕(7.5%)、头痛(4.9%)。在121例药物不良反应(ADRs)中,最常见的是干呕(4.4%)、头痛(1.8%)和头晕(1.7%)。在55例严重AE中,最常见的是肛门生殖器疣(1.1%)。在2例严重ADR中,均无意外情况,且均已缓解。在接受阿巴卡韦/多替拉韦/拉米夫定治疗时发生AE的风险在接受其他疾病合并用药的患者中似乎尤其增加。阿巴卡韦/多替拉韦/拉米夫定有效地抑制了HIV-1(96.1%的患者血浆HIV-1 RNA<50拷贝/mL),并且根据医生评估,99.0%的患者症状有所改善。

结论

这项PMS研究结果表明,作为高效抗逆转录病毒疗法使用的阿巴卡韦/多替拉韦/拉米夫定在HIV-1感染患者中耐受性良好且有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d704/10551717/30c3160a0b04/ic-55-337-g001.jpg

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