HIV Treatment Combo Noninferior to Abacavir
Tenofovir alafenamide plus emtricitabine is noninferior to abacavir plus lamivudine for the maintenance of virological suppression patients with human immunodeficiency virus type 1 (HIV-1), according to the results of a recent phase 3 trial.
For their trial, the researchers assessed 501 adult participants with virologically suppressed HIV-1 who were treated with a stable 3-drug regimen containing abacavir plus lamivudine.
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Participants were randomly assigned to either switch to treatment with 10 mg or 25 mg fixed-dose tablets of tenofovir alafenamide plus 200 mg emtricitabine (n = 253) or continue treatment with 600 mg abacavir plus 300 mg lamivudine, with matching placebo, while continuing the third drug (boosted protease inhibitor or another drug; n = 248).
Findings indicated that tenofovir alafenamide plus emtricitabine was noninferior to abacavir plus lamivudine. A total of 227 (90%) of participants treated with tenofovir alafenamide plus emtricitabine compared with 230 (93%) participants treated with abacavir plus lamivudine had maintained virological suppression.
The researchers noted that few participants discontinued treatment due to adverse events, and that no treatment related deaths occurred.
“Tenofovir alafenamide, in combination with emtricitabine and various third drugs, maintained high efficacy with a renal and bone safety profile similar to that of abacavir,” the researchers concluded. “In virologically suppressed patients, a regimen containing tenofovir alafenamide could be an alternative to those containing abacavir, without concern for new onset of renal or bone toxicities or hyperlipidemia.”
—Christina Vogt
Reference:
Winston A, Post FA, DeJesus E, et al. Tenofovir alafenamide plus emtricitabine versus abacavir plus lamivudine for treatment of virologically suppressed HIV-1-infected adults: a randomised, double-blind, active-controlled, non-inferiority phase 3 trial [Published online February 20, 2018]. Lancet HIV. https://doi.org/10.1016/S2352-3018(18)30010-9.