Doravirine: A Return of the NNRTI Class?

Area of Science:

• Antiviral drug research
• HIV/AIDS therapeutics
• Pharmacology

Background:

• Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are a key class of antiretroviral (ARV) therapy for HIV.
• The utility of NNRTIs has decreased due to newer, more tolerable ARV agents.
• Treatment failure and intolerance remain challenges with existing first-line HIV therapies.

Purpose of the Study:

• To evaluate doravirine (DOR) against other non-nucleoside reverse transcriptase inhibitors (NNRTIs).
• To review safety and efficacy data for DOR from clinical trials.
• To determine the potential role of DOR in HIV treatment regimens.

Main Methods:

• Literature search of PubMed (inception-June 2019) using terms related to HIV, doravirine, and NNRTIs.
• Inclusion of Phase 2 and 3 clinical trial data published in English.
• Identification of ongoing trials via ClinicalTrials.gov.

Main Results:

• Doravirine (DOR) received US FDA approval based on two Phase 3 noninferiority trials.
• Additional studies are ongoing to explore DOR's use in various clinical situations.
• DOR is a novel NNRTI with a favorable safety profile compared to older NNRTIs.

Conclusions:

• Doravirine (DOR) is a new NNRTI that may be suitable for treatment-naïve patients.
• DOR presents a potential alternative to existing NNRTIs, with fewer adverse effects.
• The precise place of DOR within current HIV treatment guidelines is still under investigation.