Studies Flashcards
What did the ATLAS study look at?
Suppressed switch to injectable RPV/CAB vs continuing oral therapy
End point - VL <50 at 48 weeks
What was the outcome of ATLAS study
Monthly CAB/RPV injectables non inferior to oral therapy
What did ATLAS 2M look at?
2 monthly vs 1 monthly injectable CAB/RPV
Outcome of ATLAS 2M
2 monthly injections non inferior to monthly.
However 1.5% on 2 monthly had CVF (<1 on monthly) hence strict criteria for having injectables ‘caution if patient has at least 2 of bmi > 30, subtype a1/a6, incomplete resistance testing and tx history’
Outcome of DUALIS study
Switching to dolutegravir plus boosted darunavir non inferior to continuing 3Dr with boosted darunavir in suppressed patients already on bDRV
ACTG 5257
Raltegravir superior to darunavir/ritonavir which is superior to atazanavir ritonavir
DAWNING study
In treatment failure with with NNRTI resistance - DTG is superior to lop/r
NADIA
If treatment failure with NNRTI resistance DTG non inferior to darunavir/r
What study compared AZT/3TC with TDF/3TC risk of virological failure?
NADIA
TDF/3TC associated with reduced risk of VF at 96wks
Risk of emergence of DTG resistance also less in TDF group
RAKAI study
If undetectable cannot pass virus on
DAD study
Ongoing use of abacavir increase risk of stroke and heart attack particularly in those already at high risk (>10%)
ADNES study
3TC/drv/r vs 3TC/drv/r/tdf
2 drug arm non inferior
No significant adverse events
Significantly greater total cholesterol in 2Dr so TDF may have favourable impact on lipids
GEMINI 1 and 2
Dtg/3TC - individual components vs dtg/tdf/ftc
1 and 2 in different studies
Naive adults
Now at week 144
VL 1000-500000, no mutations, no HBV or HCV
At 48 weeks non inferiority of 2drug arm
One significant failure between 96 and 144 weeks - found to have m184v and II resistance mutations
TANGO
Stable switch from 3DR to DTG/3TC as dovato
All had to be on TAF based regimen prior to switch
Dovato noninferior at 48weeks
Therefore is recommended as a stable switch option
TANGO - m184v?
Proviral m184v looked at - these patients still suppressed