Dolutegravir Plus Abacavir-Lamivudine Beats Combo Therapy

Dolutegravir Plus Abacavir-Lamivudine Beats Combo Therapy

Superior to efavirenz-tenofovir disoproxil fumarate-emtricitabine for HIV 1-infected, tx-naive patients

WEDNESDAY, Nov. 6 (HealthDay News) -- 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.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1215541 )