Studies Flashcards

1
Q

What did the ATLAS study look at?

A

Suppressed switch to injectable RPV/CAB vs continuing oral therapy
End point - VL <50 at 48 weeks

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2
Q

What was the outcome of ATLAS study

A

Monthly CAB/RPV injectables non inferior to oral therapy

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3
Q

What did ATLAS 2M look at?

A

2 monthly vs 1 monthly injectable CAB/RPV

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4
Q

Outcome of ATLAS 2M

A

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’

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5
Q

Outcome of DUALIS study

A

Switching to dolutegravir plus boosted darunavir non inferior to continuing 3Dr with boosted darunavir in suppressed patients already on bDRV

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6
Q

ACTG 5257

A

Raltegravir superior to darunavir/ritonavir which is superior to atazanavir ritonavir

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7
Q

DAWNING study

A

In treatment failure with with NNRTI resistance - DTG is superior to lop/r

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8
Q

NADIA

A

If treatment failure with NNRTI resistance DTG non inferior to darunavir/r

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9
Q

What study compared AZT/3TC with TDF/3TC risk of virological failure?

A

NADIA
TDF/3TC associated with reduced risk of VF at 96wks
Risk of emergence of DTG resistance also less in TDF group

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10
Q

RAKAI study

A

If undetectable cannot pass virus on

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11
Q

DAD study

A

Ongoing use of abacavir increase risk of stroke and heart attack particularly in those already at high risk (>10%)

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12
Q

ADNES study

A

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

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13
Q

GEMINI 1 and 2

A

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

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14
Q

TANGO

A

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

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15
Q

TANGO - m184v?

A

Proviral m184v looked at - these patients still suppressed

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16
Q

SALSA

A

Stable switch from diverse baseline regimens to DTG/3TC

Dovato non inferior at week 48

17
Q

Gs1489

A

Biktarvy vs TMQ
Non inferiority
Naives

18
Q

Gs1490

A

Naives
Biktarvy vs descovy DTG
non inferiority at 96 weeks

19
Q

DRIVE-AHEAD

A

Naives delstrigo vs atripla
No resistance, VL >1000
Non inferiority
Neuropsychiatric SEs less in delstrigo than atripla arm

20
Q

DRIVE-FORWARD

A

2NRTI + doravirine vs 2NRTI+drv/r
Non inferiority

21
Q

SWORD

A

Switch vs continuing on 1st or 2nd combination
Showed non inferiority
One k101k/e at 36 weeks - virological withdrawl- had been non adherent. Resuppreased on juluca. No II resistance.

22
Q

LATTE studies 1 and 2

A

Phase 2 studies of injectables

23
Q

DRIVE-SWITCH

A

Delstrigo switch study
Non inferior

24
Q

FLAIR

A

‘Recently naive’
All had 20 weeks TMQ
After this continues TMQ or went onto cab/RPV
CAB/RPV Non inferior to TMQ

25
Q

BRIGHTE

A

Fostemsavir study
Phase 3 study

26
Q

CALIBRATE

A

lenacapavir
4 treatment groups
2 arms 2DR and 2 3DR

Equivalent viral suppression groups
Some failure with resistance in Lenacapavir 6 monthly arms - ?missing oral doses

27
Q

CAPELLA

A

Highly treatment experienced individuals
Adding LEN to optimised background regimen - this lead to reasonable viral suppression
Again some failure in 6/12 s/c LEN with resistance ?not adhering to oral whence

28
Q

START study

A

Immediate ART vs deferred therapy until CD4 <350

53% risk reduction at interim review
Trial stopped early
Guidelines changed for treatment to be started irrespective of CD4 count

29
Q

Which trial demonstrated increased neonatal death and prematurity with combo of TDF/FTC LOP/r?

A

PROMISE

30
Q

Partner 1

A

MSM and heterosexual couples - no transmissions when positive partner suppressed

31
Q

Partner 2

A

Further data on MSM - 76000 episodes condomless sex zero transmissions

32
Q

Opposites attract

A

MSM serodifferent - zero transmissions

33
Q

Actg 5164 - when to start therapy in context of aids defining infection or bacterial infection and cd4 <200

A

Fewer aids progressions/deaths and improved cost effectiveness with ART initiated within 14 days compared to after tx of compared to waiting until infection treated
No increased IRIS but most had pcp

34
Q

COAT study

A

Cryptococcal meningitis - higher risk of death with early art initiation in those with decreased level of consciousness or acellular spinal fluid

Therefore defer ART 2 weeks

35
Q

START

A

For those with CD4 > 500 art was associated with significant reduction in relative risk of disease progression but absolute risk relatively small (4.1% deferred arm 1.8% immediate treatment arm)

36
Q

ADVANCE study

A

Week 48 DTG non inferior to EFV but DTG arm less discontinuation due to adverse events

37
Q

Spring2

A

Dtg vs RAL
48 weeks no significant difference
96 weeks favoured success with DTG

Less virological failure on DTG
Less failure with resistance on DTG

38
Q

FLAMINGO

A

DTG vs DRV/r

DTG superior - fever discontinuations but no difference in rates of virological failure or resistance

39
Q

Actg 5257 RAL VS DRV/r

A

DRV/r higher proportion of failure but those on RAL more likely to develop resistance