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转换为固定剂量复方多替拉韦/拉米夫定两药方案后的患者报告结局:SALSA研究的48周结果

Patient-Reported Outcomes After Switching to a 2-Drug Regimen of Fixed-Dose Combination Dolutegravir/Lamivudine: 48-Week Results from the SALSA Study.

作者信息

Kumar Princy, Clarke Amanda E, Jonsson-Oldenbüttel Celia, Deltoro Miguel García, Di Giambenedetto Simona, Brites Carlos, Hocqueloux Laurent, Lu Po-Liang, Oyee James, Oglesby Alan, Wynne Brian, Jones Bryn, Evitt Lee A, Fox Dainielle, Kisare Michelle, Priest Julie

机构信息

Georgetown University Medical Center, Washington, DC, USA.

Royal Sussex County Hospital and Brighton & Sussex Medical School, Brighton, UK.

出版信息

AIDS Behav. 2025 Jan;29(1):235-245. doi: 10.1007/s10461-024-04479-9. Epub 2024 Sep 3.

Abstract

Patient-reported outcomes (PROs) facilitate communication between patients and providers, enhancing patient-centered care. We report PROs for virologically suppressed people living with HIV-1 who switched to dolutegravir/lamivudine (DTG/3TC) or continued their 3- or 4-drug current antiretroviral regimen (CAR) in the phase 3 SALSA study. Secondary endpoints included change from baseline in HIV Treatment Satisfaction Questionnaire (status version; HIVTSQs) and HIV Symptom Distress Module (HIV-SDM) at Weeks 4, 24, and 48. A post hoc analysis assessed change in HIVTSQs and HIV-SDM by age (≥ 50 and < 50 years). Higher HIVTSQs scores represent greater treatment satisfaction (range, 0-60); lower HIV-SDM scores indicate less symptom bother (range, 0-80). Participants in the DTG/3TC (n = 246) and CAR (n = 247) groups reported comparable baseline HIVTSQs total scores (mean [SD], 55.2 [6.5] and 55.8 [5.5], respectively). Beginning at Week 4, mean HIVTSQs scores in the DTG/3TC group further increased vs. CAR and were sustained through Week 48. Baseline mean (SD) HIV-SDM symptom bother scores were comparable between the DTG/3TC (9.0 [9.9]) and CAR (7.9 [9.3]) groups. Small improvements in HIV-SDM scores favoring DTG/3TC were observed at Weeks 4 and 24 and sustained through Week 48 (though not significant between groups). Participants aged ≥ 50 and < 50 years who switched to DTG/3TC reported higher satisfaction and less symptom distress vs. CAR; these results were generally comparable between age groups. Participants who switched to DTG/3TC reported rapid and sustained improvements in treatment satisfaction compared with those who continued CAR, reinforcing the benefits of DTG/3TC beyond virologic suppression (NCT04021290; registration date, 7/11/2019).

摘要

患者报告结局(PROs)有助于患者与医疗服务提供者之间的沟通,加强以患者为中心的护理。我们在3期SALSA研究中报告了转换为多替拉韦/拉米夫定(DTG/3TC)或继续使用其三联或四联当前抗逆转录病毒治疗方案(CAR)的HIV-1病毒学抑制患者的PROs。次要终点包括在第4、24和48周时,HIV治疗满意度问卷(状态版;HIVTSQs)和HIV症状困扰模块(HIV-SDM)相对于基线的变化。一项事后分析按年龄(≥50岁和<50岁)评估了HIVTSQs和HIV-SDM的变化。HIVTSQs得分越高表示治疗满意度越高(范围为0至60);HIV-SDM得分越低表明症状困扰越少(范围为0至80)。DTG/3TC组(n = 246)和CAR组(n = 247)的参与者报告的基线HIVTSQs总分相当(均值[标准差]分别为55.2[6.5]和55.8[5.5])。从第4周开始,DTG/3TC组的HIVTSQs平均得分相对于CAR组进一步升高,并持续至第48周。DTG/3TC组(9.0[9.9])和CAR组(7.9[9.3])的基线HIV-SDM症状困扰平均分相当。在第4周和第24周时,观察到DTG/3TC组的HIV-SDM得分有小幅改善,并持续至第48周(尽管两组之间无显著差异)。转换为DTG/3TC的≥50岁和<50岁参与者相对于CAR组报告了更高的满意度和更少的症状困扰;这些结果在各年龄组之间总体相当。与继续使用CAR的参与者相比,转换为DTG/3TC的参与者报告治疗满意度迅速且持续提高,这进一步证明了DTG/3TC在病毒学抑制之外的益处(NCT04021290;注册日期,2019年7月11日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3cc/11739274/413f73d69b6c/10461_2024_4479_Fig1_HTML.jpg

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