Etravirine in protease inhibitor-free antiretroviral combination therapies

Etravirine (ETR) is a next generation non-nucleoside reverse transcriptase inhibitor (NNRTI). The studies for ETR EMA approval were almost exclusively performed together with the protease inhibitor (PI) darunavir. However the fact that ETR can be active against NNRTI-pretreated HIV variants and that it is well tolerated suggests its application in PI-free antiretroviral combination therapies. Although approved only for PI-containing therapies, a number of ETR treatments without PIs are performed currently. To evaluate the performance of ETR in PI-free regimens, we analyzed the EURESIST database. We observed a total of 70 therapy switches to a PI-free, ETR containing antiretroviral combination with detectable baseline viral load. 50/70 switches were in male patients and 20/70 in females. The median of previous treatments was 10. The following combinations were detected in the EURESIST database: ETR+MVC+RAL (20.0%); ETR+FTC+TDF (18.6%); 3TC+ETR+RAL (7.1%); 3TC+ABC+ETR (5.7%); other combinations (31.4%). A switch was defined as successful when either ≤50 copies/mL or a decline of the viral load of 2 log 10 , both at week 24 (range 18-30) were achieved. The overall success rate (SR) was 77% (54/70), and for the different combinations: ETR+MVC+RAL =78.6% (11/14); ETR+FTC+TDF =92.3% (12/13); 3TC+ETR+RAL =80.0% (4/5), 3TC+ABC+ETR =100% (SR 4/4); and for other combinations =67.6% (23/34). These SR values are comparable to those for other therapy combinations in such pretreated patients. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Schuelter E et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18260 http://www.jiasociety.org/index.php/jias/article/view/18260 | http://dx.doi.org/10.7448/IAS.15.6.18260