Evidence map›Paper›PMID 27515949›Full record

Observational studyBMC infectious diseases2016

Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter observational study.

Alessandra Latini, Massimiliano Fabbiani, Vanni Borghi, Gaetana Sterrantino, Alberto Giannetti, Patrizia Lorenzini, Laura Loiacono, Adriana Ammassari, Rita Bellagamba, Manuela Colafigli and 4 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Observational
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

14 authors.

Alessandra LatiniSan Gallicano Dermatologic Institute (IRCCS), Clinic of Dermatology and Infectious Diseases, Rome, Italy.
Massimiliano FabbianiDepartment of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.
Vanni BorghiAzienda Ospedaliero Universitaria, Clinic of Infectious Diseases, Modena, Italy.
Gaetana SterrantinoDivision of Infectious Diseases, Careggi Hospital, Florence, Italy.
Alberto GiannettiClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Patrizia LorenziniClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Laura LoiaconoClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Adriana AmmassariClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Rita BellagambaClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Manuela ColafigliSan Gallicano Dermatologic Institute (IRCCS), Clinic of Dermatology and Infectious Diseases, Rome, Italy.
Gabriella D'EttorrePoliclinico Universitario "Umberto I", Clinic of Infectious Diseases, Rome, Italy.
Simona Di GiambenedettoDepartment of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.
Andrea AntinoriClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
Mauro ZaccarelliClinical Department, National Institute for the Infectious Diseases "Lazzaro Spallanzani", Rome, Italy. mauro.zaccarelli@inmi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAim of the study was to assess predictors of discontinuation/toxicity of boosted PI-based (PI/r) dual therapy (DT).

methodsObservational, retrospective switch study in patients successfully treated with triple drugs regimen. Patients switched to PI/r based DT [darunavir (DRV/r), lopinavir (LPV/r) or atazanavir (ATV/r)] plus a second drug: [raltegravir (RAL), maraviroc (MVC) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF)] between 2009 and 2014 were included. The effect of each drug as well as other clinical and virological cofactors over treatment discontinuation (TD) was assessed using survival analysis.

resultsOverall, 376 patients were included with mean follow-up of 73 weeks. The most commonly used drugs in DT were DRV/r (63.0 %) and RAL (53.7 %). TD was observed in 77 (20,4 %) patients: 38 (10,1 %) virological failure, 35 (9,3 %) toxicity/intolerance (4 deaths) and 4 (1 %) interruptions for patients decision. At Cox Model, adjusted by demographic and laboratory variables, DRV/r and ATV/r significantly reduced the likelihood of TD and longer treatment was associated with lower risk, while low CD4 count at baseline and number of previous regimens with a higher risk. Moreover, RAL and 3TC use were significantly associated with lower TD by toxicity.

conclusionsIn our clinical practice experience, switching virologically suppressed patients to PI/r based DT showed adequate safety and efficacy, so that it may be used in selected patients with specific medical needs.

Indexed as

Anti-HIV AgentsAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountDarunavirDrug Therapy, CombinationFemaleFollow-Up StudiesHIV InfectionsHIV Protease InhibitorsHumansLamivudineLopinavirMaleMedication AdherenceMiddle AgedProportional Hazards ModelsAnti-HIV AgentsDarunavirHIV Protease InhibitorsLamivudineLopinavirRaltegravir PotassiumTenofovirAntiretroviral therapyDarunavir AtazanavirDual therapyRaltegravirTreatment simplification

Identifiers

PMID27515949
PMCPMC4982404

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.