Department of Pharmacy Practice, East Tennessee State University Bill Gatton College of Pharmacy, Johnson City, Tennessee, USA.
University of Georgia College of Pharmacy, Albany, Georgia, USA.
Pharmacotherapy. 2024 May;44(5):360-382. doi: 10.1002/phar.2914.
Treatment options are currently limited for persons with HIV-1 (PWH) who are heavily treatment-experienced and/or have multidrug-resistant HIV-1. Three agents have been approved by the U.S. Food and Drug Administration (FDA) since 2018, representing a significant advancement for this population: ibalizumab, fostemsavir, and lenacapavir. However, there is a paucity of recommendations endorsed by national and international guidelines describing the optimal use (e.g., selection and monitoring after initiation) of these novel antiretrovirals in this population. To address this gap, a modified Delphi technique was used to develop these consensus recommendations that establish a framework for initiating and managing ibalizumab, fostemsavir, or lenacapavir in PWH who are heavily treatment-experienced and/or have multidrug-resistant HIV-1. In addition, future areas of research are also identified and discussed.
目前，对于那些已经接受过多重治疗且/或具有多重耐药性 HIV-1 的 HIV-1（PWH）患者，治疗选择有限。自 2018 年以来，有三种药物已被美国食品和药物管理局（FDA）批准，这代表着该人群的重大进展：ibalizumab、fostemsavir 和 lenacapavir。然而，国家和国际指南中缺乏关于这些新型抗逆转录病毒药物在该人群中的最佳使用（例如，起始后的选择和监测）的推荐。为了解决这一差距，采用改良 Delphi 技术制定了这些共识建议，为起始和管理已接受过多重治疗且/或具有多重耐药性 HIV-1 的 HIV-1 患者中的 ibalizumab、fostemsavir 或 lenacapavir 建立了框架。此外，还确定并讨论了未来的研究领域。
