Williams Valerie, Cory Theodore James
Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
Expert Opin Pharmacother. 2025 Jan;26(1):9-15. doi: 10.1080/14656566.2024.2440000. Epub 2024 Dec 10.
HIV is a global disease affecting millions of people. While treatments have improved over the past decades, treatment failure remains a significant issue for treatment experienced patients. Doravirine/islatravir is a new dual-therapy regimen with a promising resistance profile and reductions in central nervous system effects. Recent trials have shown non-inferiority compared to current standards of care. However, current research suggests that CD4 counts decrease in an islatravir-dose dependent manner, but more data is needed to determine the full extent of this effect at lower doses.
Doravirine/islatravir is a therapeutic combination for the treatment of HIV which is currently in Phase 3 trials. This article reviews key studies regarding the safety and efficacy of the combination.
When approved, doravirine/islatravir should be considered for patients who have previously failed treatment due to viral resistance. It expands the selection of two-drug single-pill therapies and introduces a novel mechanism of action to the market. However, more data is needed regarding the effects of islatravir on CD4 counts. ISL doses as low as 0.25 mg proved non-inferior to current treatments. Therefore, evaluation of the long-term efficacy and safety of DOR/ISL should focus on reduced doses of ISL and minimizing CD4 reduction.
艾滋病病毒是一种影响数百万人的全球性疾病。尽管在过去几十年里治疗方法有所改进，但治疗失败对于有治疗经验的患者来说仍然是一个重大问题。多韦拉韦/依斯拉曲韦是一种新的双联疗法方案，具有良好的耐药性，且可减少中枢神经系统副作用。近期试验表明，与当前的标准治疗相比，该方案并不逊色。然而，目前的研究表明，依斯拉曲韦剂量依赖性地降低CD4细胞计数，但需要更多数据来确定较低剂量下这种效应的全部程度。
多韦拉韦/依斯拉曲韦是一种用于治疗艾滋病病毒的治疗组合，目前正处于3期试验阶段。本文回顾了有关该组合安全性和有效性的关键研究。
获批后，对于因病毒耐药性而此前治疗失败的患者，应考虑使用多韦拉韦/依斯拉曲韦。它扩大了双药单片疗法的选择范围，并为市场引入了一种新的作用机制。然而，关于依斯拉曲韦对CD4细胞计数的影响，还需要更多数据。低至0.25毫克的依斯拉曲韦剂量已证明不逊色于当前治疗方法。因此，对多韦拉韦/依斯拉曲韦长期疗效和安全性的评估应侧重于降低依斯拉曲韦剂量并尽量减少CD4细胞减少。
