Russo Antonio, Martini Salvatore, Pisaturo Mariantonietta, Palamone Maria Grazia, Russo Maria Teresa, Zollo Verdiana, Palladino Roberta, Grimaldi Pierantonio, Borghetti Alberto, De Socio Giuseppe Vittorio, Fabbiani Massimiliano, Coppola Nicola
Department of Mental Health and Public Medicine - Infectious Disease Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
Infectious Diseases Clinic, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Infect Chemother. 2024 Sep;56(3):395-405. doi: 10.3947/ic.2024.0066.
The aim of this meta-analysis was to synthesize the available evidence from the literature on the efficacy and safety of integrase inhibitor-based two drug regimens compared to triple drug regimens in virosuppressed people living with HIV (PLWH) in a long-term follow-up (at 96 weeks).
A systematic review and meta-analysis were conducted to evaluate the efficacy, safety, and adverse drug reactions leading to discontinuation of two drug regimens compared to triple drug regimens in virosuppressed PLWH patients at 96 weeks of follow-up. We searched MEDLINE, Google Scholar, and the Cochrane Library up to March 15, 2024, and studies were selected for eligibility based on predefined criteria. Data were extracted independently by two reviewers, and risk ratios (RRs) were calculated as the measure of association between therapy and incidence of events.
Six studies were included in the analysis, both clinical trials and observational studies. The two drug regimens included cabotegravir/rilpivirine, dolutegravir/lamivudine, and dolutegravir/rilpivirine. No significant differences were observed in treatment failure (RR, 0.77; 95% confidence interval [CI], 0.53-1.13; =0.182), virological failure (RR, 0.79; 95% CI, 0.48-1.29; =0.341), adverse drug reactions leading to discontinuation (RR, 1.74; 95% CI, 0.73-4.17; =0.215), or appearance of mutation (RR, 2.48; 95% CI, 0.33-18.68; =0.379) between two drug regimen and triple drug regimen groups at 96 weeks of follow up.
The meta-analysis provide an overview of the available evidence and supports the use of two drug regimens as an option for simplifying treatment and improving clinical outcomes in virosuppressed PLWH.
本荟萃分析的目的是综合文献中的现有证据，比较整合酶抑制剂为基础的两药方案与三药方案在长期随访（96周）的病毒抑制的HIV感染者（PLWH）中的疗效和安全性。
进行了一项系统评价和荟萃分析，以评估在96周随访时，与三药方案相比，两药方案在病毒抑制的PLWH患者中的疗效、安全性及导致停药的药物不良反应。我们检索了截至2024年3月15日的MEDLINE、谷歌学术和考克兰图书馆，根据预先设定的标准选择符合条件的研究。由两名审阅者独立提取数据，并计算风险比（RRs）作为治疗与事件发生率之间关联的度量。
分析纳入了六项研究，包括临床试验和观察性研究。两药方案包括卡博特韦/利匹韦林、多替拉韦/拉米夫定和多替拉韦/利匹韦林。在96周随访时，两药方案组和三药方案组在治疗失败（RR，0.77；95%置信区间[CI]，0.53 - 1.13；P = 0.182）、病毒学失败（RR，0.79；95% CI，0.48 - 1.29；P = 0.341）、导致停药的药物不良反应（RR，1.74；95% CI，0.73 - 4.17；P = 0.215）或突变出现（RR，2.48；95% CI，0.33 - 18.68；P = 0.379）方面均未观察到显著差异。
该荟萃分析提供了现有证据的概述，并支持使用两药方案作为简化病毒抑制的PLWH治疗并改善临床结局的一种选择。
