Evidence map›Paper›PMID 31464642›Full record

Trial reportAIDS research and therapy2019

Darunavir/cobicistat/emtricitabine/tenofovir alafenamide in treatment-experienced, virologically suppressed patients with HIV-1: subgroup analyses of the phase 3 EMERALD study.

Gregory D Huhn, Joseph J Eron, Pierre-Marie Girard, Chloe Orkin, Jean-Michel Molina, Edwin DeJesus, Romana Petrovic, Donghan Luo, Erika Van Landuyt, Erkki Lathouwers and 3 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in AIDS research and therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02269917 (A Phase 3, Randomized, Active-controlled, Open-label Study to Evaluate the Efficacy, Safety and Tolerability of Switching to a Darunavir/ Cobicistat/ Emtricitabine/ Tenofovir Alafenamide), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% 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.

NCT02269917 phase3completednot on this map

A Phase 3, Randomized, Active-controlled, Open-label Study to Evaluate the Efficacy, Safety and Tolerability of Switching to a Darunavir/ Cobicistat/ Emtricitabine/ Tenofovir Alafenamide (D/C/F/TAF) Once-daily Single-tablet Regimen Versus Continuing the Current Regimen Consisting of a Boosted Protease Inhibitor (bPI) Combined With Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF) in Virologically-suppressed, Human Immunodeficiency Virus Type 1 (HIV-1) Infected Subjects

TypeinterventionalSponsorJanssen R&D IrelandRan2015 to 2020Enrolled1,149ConditionsHuman Immunodeficiency Virus Type 1ArmsD/C/F/TAF, Boosted Protease Inhibitor (bPI), FTC/TDF
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
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

13 authors at 9 institutions in 4 countries.

Gregory D HuhnThe Ruth M. Rothstein CORE Center, 2020 W Harrison Street, Chicago, IL, 60612, USA. ghuhn@cookcountyhhs.org.
Joseph J EronUniversity of North Carolina School of Medicine, 321 S Columbia St., Chapel Hill, NC, 27516, USA.
Pierre-Marie GirardHôpital St Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne University, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
Chloe OrkinQueen Mary University of London, Mile End Rd, Bethnal Green, London, E1 4NS, UK.
Jean-Michel MolinaUniversity of Paris Diderot, St-Louis Hospital, 12 Rue de la Grange aux Belles, 75010, Paris, France.
Edwin DeJesusOrlando Immunology Center, 1707 North Mills Avenue, Orlando, FL, 32803, USA.
Romana PetrovicJanssen Research & Development, Turnhoutseweg 30, 2340, Beerse, Belgium.
Donghan LuoJanssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA.
Erika Van LanduytJanssen Research & Development, Turnhoutseweg 30, 2340, Beerse, Belgium.
Erkki LathouwersJanssen Research & Development, Turnhoutseweg 30, 2340, Beerse, Belgium.
Richard E NettlesJanssen Scientific Affairs, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA.
Kimberley BrownJanssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA.
Eric Y WongJanssen Scientific Affairs, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA.
Janssen (Belgium) · BEJanssen Scientific Affairs (United States)Janssen (United States) · USAssistance Publique – Hôpitaux de Paris · FRDélégation Paris 7 · FROrlando Immunology Center · USQueen Mary University of London · GBRuth M. Rothstein CORE Center · USUniversity of North Carolina at Chapel Hill · 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

backgroundDarunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg is a once-daily, single-tablet regimen for treatment of HIV-1 infection. The efficacy/safety of switching to D/C/F/TAF versus continuing boosted protease inhibitor (bPI) + emtricitabine/tenofovir disoproxil fumarate (control) were demonstrated in a phase 3, randomized study (EMERALD) of treatment-experienced, virologically suppressed adults through week 48. The objective of this analysis was to evaluate EMERALD outcomes across subgroups of patients based on demographic characteristics, prior treatment experience, and baseline antiretroviral regimen.

methodsEMERALD patients were virologically suppressed (viral load [VL] < 50 copies/mL for ≥ 2 months at screening). Prior non-darunavir virologic failure (VF) was allowed. Primary endpoint was proportion of patients with virologic rebound (confirmed VL ≥ 50 copies/mL) cumulative through week 48. Virologic response was VL < 50 copies/mL (FDA snapshot). Safety was assessed by adverse events, renal proteinuria markers, and bone mineral density. Outcomes were examined for prespecified subgroups by age (≤/> 50 years), gender, race (black/non-black), prior number of antiretrovirals used (4/5/6/7/> 7), prior VF (0/≥ 1), baseline bPI (darunavir/atazanavir or lopinavir), and baseline boosting agent (ritonavir/cobicistat).

resultsAmong 1141 patients in the D/C/F/TAF (n = 763) and control (n = 378) arms, virologic rebound rates (2.5% and 2.1%, respectively) were similar, and this was consistent across all subgroups. Virologic response rates ranged from 91 to 97% (D/C/F/TAF) and 89 to 99% (control) across all subgroups, with differences between treatment arms of 0 and 6%. Adverse event rates were low in both arms and across subgroups. Improvements in renal and bone parameters were observed with D/C/F/TAF across demographic subgroups.

conclusionsFor treatment-experienced, virologically suppressed patients, switching to D/C/F/TAF was highly effective and safe, regardless of demographic characteristics, prior treatment experience, or pre-switch bPI. Trial registration ClinicalTrials.gov Identifier: NCT02269917. Registered 21 October 2014. https://clinicaltrials.gov/ct2/show/NCT02269917.

Indexed as

Drug SubstitutionAdenineAdultAgedAlanineAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveCobicistatDarunavirDrug CombinationsEmtricitabineFemaleHIV-1HIV InfectionsHumansMaleAdenineAlanineAnti-HIV AgentsCobicistatDarunavirDrug CombinationsEmtricitabineProtease InhibitorsTabletsTenofovirtenofovir alafenamideAntiretroviralDarunavirHIV-1Protease inhibitorSingle-tablet regimenSwitch study

Identifiers

PMID31464642
PMCPMC6716878
OpenAlexW2970486667

What OpenQuestion holds

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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.