Evidence map›Paper›PMID 29771789›Full record

Trial reportJournal of acquired immune deficiency syndromes (1999)2018

Raltegravir 1200 mg Once Daily vs 400 mg Twice Daily, With Emtricitabine and Tenofovir Disoproxil Fumarate, for Previously Untreated HIV-1 Infection: Week 96 Results From ONCEMRK, a Randomized, Double-Blind, Noninferiority Trial.

Pedro Cahn, Paul E Sax, Kathleen Squires, Jean-Michel Molina, Winai Ratanasuwan, Mohammed Rassool, Mark Bloch, Xia Xu, Yan Zhou, Brenda Homony and 6 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of acquired immune deficiency syndromes (1999), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02131233 (A Phase III Multicenter, Double-Blind, Randomized, Active Comparator-Controlled Clinical Trial to Evaluate the Safety and Efficacy of Reformulated Raltegravir 1200 mg Once Daily Versus Raltegravir 400 mg Twice Daily, Each in Combination With TRUVADA™, in Treatment-Naïve HIV-1 Infected Subjects), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–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.

NCT02131233 phase3completednot on this map

A Phase III Multicenter, Double-Blind, Randomized, Active Comparator-Controlled Clinical Trial to Evaluate the Safety and Efficacy of Reformulated Raltegravir 1200 mg Once Daily Versus Raltegravir 400 mg Twice Daily, Each in Combination With TRUVADA™, in Treatment-Naïve HIV-1 Infected Subjects

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2014 to 2016Enrolled802ConditionsHIV InfectionArmsReformulated Raltegravir, Raltegravir, TRUVADA™, Placebo to Reformulated Raltegravir, Placebo to Raltegravir
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Antiretroviral therapy and liver disorders in the OPERATherapeutic advances in drug safety · 2020
    Article
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

16 authors.

Pedro CahnFundación Huesped, Buenos Aires, Argentina.
Paul E SaxBrigham and Women's Hospital, Harvard Medical School, Boston, MA.
Kathleen SquiresThomas Jefferson University, Philadelphia, PA.
Jean-Michel MolinaHôpital Saint-Louis, University of Paris Diderot, Paris, France.
Winai RatanasuwanFaculty of Medicine Siriraj Hospital, Clinical HIV Research Unit, Mahidol University, Bangkok, Thailand.
Mohammed RassoolUniversity of Witwatersrand, Helen Joseph Hospital, Johannesburg, South Africa.
Mark BlochHoldsworth House Medical Practice, Sydney, Australia.
Xia XuMerck & Co., Inc., Kenilworth, NJ.
Yan ZhouMerck & Co., Inc., Kenilworth, NJ.
Brenda HomonyMerck & Co., Inc., Kenilworth, NJ.
Deborah HeplerMerck & Co., Inc., Kenilworth, NJ.
Hedy TepplerMerck & Co., Inc., Kenilworth, NJ.
George J HannaMerck & Co., Inc., Kenilworth, NJ.
Bach-Yen NguyenMerck & Co., Inc., Kenilworth, NJ.
Wayne GreavesMerck & Co., Inc., Kenilworth, NJ.
ONCEMRK Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRaltegravir 1200mg (2×600mg tablets) once daily (QD) demonstrated noninferior efficacy and similar safety to raltegravir 400mg twice daily (BID) at week 48 of the ONCEMRK trial. Here, we report the week 96 results from this study.

methodsONCEMRK is a phase 3, multicenter, double-blind, noninferiority trial comparing raltegravir 1200mg QD with raltegravir 400mg BID in treatment-naive HIV-1-infected adults. Participants were assigned (2:1) to raltegravir 2×600mg QD or 400mg BID, both with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) for 96 weeks. Randomization was stratified by screening HIV-1 RNA and hepatitis B/C status. Efficacy was assessed as the proportion of participants with HIV-1 RNA <40 copies per milliliter (Food and Drug Administration Snapshot approach); the noninferiority margin was 10 percentage points.

resultsOf the 797 participants who received study therapy (84.6% were men, 59.3% were white, and mean age was 35.9 years), 694 completed 96 weeks of treatment (87.6% QD; 84.4% BID), with few discontinuations because of lack of efficacy (1.1% for both groups) or adverse events (1.3% QD; 2.3% BID). At week 96, 81.5% (433/531) of QD recipients and 80.1% (213/266) of BID recipients achieved HIV-1 RNA <40 copies per milliliter (difference 1.4%, 95% confidence interval: -4.4 to 7.3). CD4 T-cell counts increased >260 cells/mm from baseline in both groups. Resistance to raltegravir was infrequent, occurring in 0.8% of each treatment group through week 96. Adverse event rates were similar for the 2 regimens.

conclusionsIn HIV-1-infected treatment-naive adults receiving FTC/TDF, raltegravir 1200mg QD demonstrated noninferior efficacy to raltegravir 400mg BID that was durable to week 96, with a safety profile similar to raltegravir 400mg BID.

Indexed as

AdenineAdultAnti-HIV AgentsDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleDrug Therapy, CombinationEmtricitabineFemaleHIV-1HIV InfectionsHumansMalePhosphorous AcidsPlacebosRaltegravir Potassium9-(2-((bis(pivaloyloxymethoxy)phosphinoyl)methoxy)propyl)adenineAdenineAnti-HIV AgentsEmtricitabinePhosphorous AcidsPlacebosRaltegravir PotassiumRNA, Viral

Identifiers

PMID29771789
PMCPMC6075877

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Registered trials

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.