Investigators wanted to look at real world experiences with combination therapy in older people living with HIV.
As people living with HIV (PLWH) age, there is a move to have them taking less antiretrovirals, and ones with fewer drug-drug interactions (DDIs), and long-term side effects.
Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is an example of one antiretroviral that is a combination therapy looking at this population.
Past clinical trials of B/F/TAF demonstrated favorable efficacy and safety in older adults, however, data from real-world experience are needed to validate results.
As such, investigators did a retrospective analysis evaluating medical records from PLWH aged ≥ 50 years who had switched their regimen to B/F/TAF between 2/7/2018 and 5/31/2019.
The study included 306 PLWH and they identified the primary endpoint as maintaining HIV-1 RNA< 50 copies/mL at week 48. They also wanted to see if there was any impact of switching regimens to B/F/TAF on DDIs, if there were any adverse events, and safety parameters.
“At Week 48, 287 (94%) participants maintained an HIV-1 RNA< 50 copies/ml and 19 (6%) had an HIV-1 RNA between 50-200 copies/mL (Figure 1). 1 patient discontinued due to lack of efficacy,” the investigators reported. A total of 123 potential DDIs were identified in 104 (34%) patients taking a boosting agent or rilpivirine at baseline.”
In terms of ancillary benefits, there was a significant median decline in total cholesterol (15.5 mg/dL, 95% confidence interval [CI]: 9.5; 21.5), LDL cholesterol (9.5 mg/dL, 95% CI: 4; 15.5) and triglycerides (20 mg/dL, 95% CI: 9.5; 32.5). Participants median weight increased by 2.5 pounds (95% CI: 1.5; 3.5). AEs occurred in 33 (11%) patients (all Grade 1-2) and led to 7 (2%) discontinuations.
“In this real-world cohort, switching to B/F/TAF was associated with maintenance of virologic control, improvement in lipid parameters, and avoidance of DDIs in a large proportion of patients,” investigators concluded. “These data support use of B/F/TAF as a treatment option in older PLWH.”
The study, “Efficacy, safety and tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in HIV-1 infected virologically-suppressed older adults in a real-world setting,” was presented virtually at ID Week 2020.