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多伟拉韦/拉米夫定/富马酸替诺福韦二吡呋酯固定剂量复方片剂在青少年 HIV 感染者中的疗效、安全性和耐受性:来自 IMPAACT 2014 的第 96 周结果。

Efficacy, Safety, and Tolerability of Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate Fixed-Dose Combination Tablets in Adolescents Living With HIV: Results Through Week 96 from IMPAACT 2014.

机构信息

Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Pediatric Infect Dis Soc. 2023 Dec 16;12(12):602-609. doi: 10.1093/jpids/piad078.

Abstract

BACKGROUND

IMPAACT 2014 study is a phase I/II, multicenter, open-label, nonrandomized study of doravirine (DOR) co-formulated with lamivudine (3TC) and tenofovir disoproxil fumarate (TDF) as fixed-dose combination (DOR FDC) in adolescents with HIV-1. We report the efficacy, safety, and tolerability of DOR FDC through 96 weeks.

METHODS

Participants were adolescents aged 12 to <18 years who weighed at least 45 kg and who were either antiretroviral (ARV)-naïve or virologically suppressed without documented resistance mutations to DOR/3TC/TDF. The efficacy endpoint was the proportion of participants with HIV-1 RNA <40 copies/mL assessed at weeks 48 and 96 using the observed failure approach. Safety and tolerability outcomes were incidence of adverse events (AEs) and treatment discontinuations.

RESULTS

A total of 45 adolescents, median age 15 (range, 12-17) years, 58% females, were enrolled and 2 (4.4%) participants were ARV naïve. Of the 45 participants, 42 (93.3%) completed the study and 41 (91.1%) completed the study treatment. At week 48, 41/42 (97.6%; 95% confidence interval [CI], 87.4-99.9) and week 96, 37/40 (92.5%; 95% CI, 79.6-98.4) participants had achieved or maintained HIV-1 RNA <40 copies/mL. There were no treatment-related discontinuations due to AEs and no drug-related AEs ≥grade 3 or deaths.

CONCLUSIONS

We found once-daily dosing of DOR FDC to be safe and well tolerated for maintaining viral suppression through 96 weeks in adolescents living with HIV-1.

摘要

背景

IMPACT 2014 研究是一项 I/II 期、多中心、开放性、非随机研究,评估多拉韦林(DOR)与拉米夫定(3TC)和富马酸替诺福韦二吡呋酯(TDF)组成的固定剂量复方(DOR FDC)在 HIV-1 青少年中的疗效、安全性和耐受性。我们报告了通过 96 周时 DOR FDC 的疗效、安全性和耐受性。

方法

参与者为年龄在 12 至<18 岁、体重至少 45kg、且无抗逆转录病毒(ARV)治疗史或病毒学抑制但无记录的 DOR/3TC/TDF 耐药突变的青少年。疗效终点为使用观察失败法在第 48 周和第 96 周评估的 HIV-1 RNA<40 拷贝/ml 的参与者比例。安全性和耐受性结局为不良事件(AE)和治疗中断的发生率。

结果

共有 45 名青少年(中位年龄 15 岁[范围,12-17 岁];58%女性)入组,其中 2 名(4.4%)为 ARV 初治者。在 45 名参与者中,42 名(93.3%)完成了研究,41 名(91.1%)完成了研究治疗。第 48 周时,41/42 名(97.6%;95%置信区间[CI],87.4-99.9)和第 96 周时,37/40 名(92.5%;95%CI,79.6-98.4)参与者实现或维持了 HIV-1 RNA<40 拷贝/ml。无因 AE 导致的治疗相关停药,且无药物相关的≥3 级 AE 或死亡。

结论

我们发现,对于 HIV-1 青少年患者,每日一次 DOR FDC 治疗方案安全且耐受良好,可维持病毒抑制 96 周。

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