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A randomized cross-over study to compare raltegravir and efavirenz (SWITCH-ER study)
Alain Nguyen1, Alexandra Calmy, Cecile Delhumeau
1University Clinic of Infectious Diseases, University Hospital of Geneva, Switzerland. nguyena0@gmail.com
AIDS (London, England)
|May 20, 2011
Summary
Raltegravir (RAL) replacement for Efavirenz (EFV) in HIV patients showed preference for RAL, improved anxiety and stress scores, and favorable lipid profiles. Over half of participants preferred switching to RAL post-study.
Area of Science:
- Infectious Diseases
- Virology
- Pharmacology
Background:
- Efavirenz (EFV) is associated with neuropsychiatric side effects and adverse lipid profiles in HIV patients.
- Investigating the impact of switching from EFV to raltegravir (RAL) is crucial for improving patient outcomes.
- Understanding patient preference and tolerability is key in long-term HIV management.
Purpose of the Study:
- To evaluate patient preference between Efavirenz (EFV) and raltegravir (RAL).
- To assess the effects of switching from EFV to RAL on neuropsychiatric symptoms and lipid levels.
- To determine the feasibility and benefits of substituting EFV with RAL in stable HIV patients.
Main Methods:
- A randomized, double-blind, cross-over study (Switch-ER) was conducted.
- Patients on stable EFV therapy were randomized to receive either RAL or EFV for 2 weeks, then switched.
- Primary endpoint was patient preference after 4 weeks, with secondary endpoints including anxiety, sleep quality, and lipid profiles.
Main Results:
- Twenty-two out of 53 participants preferred RAL over EFV.
- Significant improvements were observed in anxiety (P=0.04) and stress scores (P=0.03) with RAL.
- Switching to RAL led to significant reductions in plasma cholesterol, triglycerides, and LDL cholesterol levels.
Conclusions:
- Half of patients on stable EFV preferred switching to RAL after a brief exposure.
- Raltegravir (RAL) substitution for Efavirenz (EFV) significantly improved lipid profiles, anxiety, and stress.
- The findings support RAL as a viable alternative to EFV for improving tolerability and metabolic parameters in HIV treatment.
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