Evidence map›Paper›PMID 26176344›Full record

Trial reportHIV medicine2016

The ASSURE study: HIV-1 suppression is maintained with bone and renal biomarker improvement 48 weeks after ritonavir discontinuation and randomized switch to abacavir/lamivudine + atazanavir.

D A Wohl, L Bhatti, C B Small, H Edelstein, H H Zhao, D A Margolis, E DeJesus, W G Weinberg, L L Ross, M S Shaefer

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in HIV medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Therapeutic advances in chronic disease · 2019
    Article
  5. Bone Loss in HIV Infection.Current treatment options in infectious diseases · 2017
    Article
  6. Bone health in HIV and hepatitis B or C infections.Therapeutic advances in musculoskeletal disease · 2017
    Review
  7. The protease inhibitors and HIV-associated bone loss.Current opinion in HIV and AIDS · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 1 country.

D A WohlAIDS Clinical Trials Unit, University of North Carolina, Chapel Hill, NC, USA.
L BhattiAIDS Healthcare Foundation, Beverly Hills, CA, USA.
C B SmallNew York Medical College, Valhalla, NY, USA.
H EdelsteinAlameda County Medical Center, Oakland, CA, USA.
H H ZhaoGlaxoSmithKline, Research Triangle Park, Research Triangle Park, NC, USA.
D A MargolisGlaxoSmithKline, Research Triangle Park, Research Triangle Park, NC, USA.
E DeJesusOrlando Immunology Center, Orlando, FL, USA.
W G WeinbergKaiser Foundation Health Plan of Georgia, Inc., Atlanta, GA, USA.
L L RossViiV Healthcare, Research Triangle Park, NC, USA.
M S ShaeferViiV Healthcare, Research Triangle Park, NC, USA.
GlaxoSmithKline (United States) · USTriangle · USAIDS Clinical Trials Group · USAIDS Healthcare Foundation · USAlameda Health System · USKaiser Foundation Hospital · USNew York Medical College · USOrlando Immunology Center · US

Funding

Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
NIAID NIH HHS P30 AI050410
6 · The paper itself

Abstract

objectivesHIV treatment guidelines endorse switching or simplification of antiretroviral therapy in therapy-experienced patients with suppressed viraemia; ritonavir discontinuation may also enhance tolerability and reduce long-term adverse events (AEs). This open-label, multicentre, noninferiority study enrolled HIV-1-infected, treatment-experienced adults with confirmed HIV-1 RNA ≤ 75 HIV-1 RNA copies/mL currently receiving tenofovir/emtricitabine + atazanavir/ritonavir (TDF/FTC + ATV/r) for ≥ 6 months with no reported history of virological failure.

methodsParticipants were randomized 1:2 to continue current treatment or switch to abacavir/lamivudine + atazanavir (ABC/3TC + ATV). Endpoints included the proportion of participants with HIV-1 RNA < 50 copies/mL by time to loss of virological response (TLOVR), AEs, fasting lipids, and inflammatory, coagulation, bone and renal biomarkers.

resultsAfter 48 weeks, 76% (152 of 199) of ABC/3TC + ATV-treated and 79% (77 of 97) of TDF/FTC + ATV/r-treated participants had HIV-1 RNA < 50 copies/mL (TLOVR; P = 0.564). Other efficacy analyses yielded similar results. Rates of new grade 2-4 AEs were 45% in both groups, but an excess of hyperbilirubinaemia made the rate of treatment-emergent grade 3-4 laboratory abnormalities higher with TDF/FTC + ATV/r (36%) compared with ABC/3TC + ATV (19%). Most fasting lipid levels remained stable over time; high-density lipoprotein (HDL) cholesterol increased modestly in ABC/3TC + ATV-treated participants. Bone and renal biomarkers improved significantly between baseline and week 48 in participants taking ABC/3TC + ATV and were stable in participants taking TDF/FTC + ATV/r. No significant changes occurred in any inflammatory or coagulation biomarker within or between treatment groups.

conclusionsThe ABC/3TC + ATV treatment-switch group had similar viral suppression rates up to 48 weeks to the TDF/FTC + ATV/r comparator group, with lower rates of moderate- to high-grade hyperbilirubinaemia and improvements in bone and renal biomarkers.

Indexed as

AbacavirAdultAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveAtazanavir SulfateBiomarkersBone DensityCD4 Lymphocyte CountDideoxynucleosidesDrug CombinationsDrug SubstitutionFemaleHIV InfectionsHumansKidneyLamivudineAbacavirabacavir, lamivudine drug combinationAnti-HIV AgentsAtazanavir SulfateBiomarkersDideoxynucleosidesDrug CombinationsLamivudineLipidsRitonavirRNA, Viralabacavirbone biomarkersHIVrenal biomarkertenofovir

Identifiers

PMID26176344
PMCPMC5034844
OpenAlexW1573880500

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.