Dolutegravir plus abacavir-lamivudine beats combo therapy
(HealthDay)—For patients with HIV-1 infection and HIV-1 RNA of 1,000 copies per mL or more, treatment with dolutegravir plus abacavir-lamivudine (DTG-ABC-3TC) is more effective through 48 weeks than combination therapy with efavirenz-tenofovir disoproxil fumarate (DF)-emtricitabine (EFV-TDF-FTC), according to a study published in the Nov. 7 issue of the New England Journal of Medicine.
Sharon L. Walmsley, M.D., from the University Health Network in Toronto, and colleagues conducted a randomized, double-blind, phase 3 study involving 833 treatment-naive adult participants with an HIV-1 RNA level of 1,000 copies per mL or more. Participants were randomly allocated to receive DTG-ABC-3TC or combination therapy with EFV-TDC-FTC.
The researchers found that the proportion of patients with an HIV-1 RNA level of less than 50 copies per mL was significantly higher in the DTG-ABC-3TC group (88 percent) than in the EFV-TDF-FTC group (81 percent) at week 48, meeting the criteria for superiority. The median time to viral suppression was shorter in the DTG-ABC-3TC group, and there were greater increases in the CD4+ T-cell count than with EFV-TDF-FTC. A lower proportion of patients in the DTG-ABC-3TC group discontinued therapy because of adverse events.
"Dolutegravir plus abacavir-lamivudine had a better safety profile and was more effective through 48 weeks than the regimen with efavirenz-tenofovir DF-emtricitabine," the authors write.
The study was funded by ViiV Healthcare, the manufacturer and/or marketer of dolutegravir and abacavir-lamivudine.
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