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Real-World Experience with Dolutegravir-Based Two-Drug Regimens
Douglas Ward1, Moti Ramgopal2, David J Riedel3
1Dupont Circle Physicians Group, Washington, DC, USA.
AIDS Research and Treatment
|July 30, 2020
Summary
Physicians prescribed dolutegravir-based 2-drug regimens (DTG 2DRs) for HIV treatment primarily for simplification and to avoid long-term toxicities. Most patients on DTG 2DRs achieved and maintained viral suppression, demonstrating its effectiveness.
Area of Science:
- Infectious Diseases
- Virology
- Clinical Pharmacy
Background:
- Dolutegravir-based 2-drug regimens (DTG 2DRs) are recognized alternatives to 3-drug antiretroviral therapy (ART) for HIV.
- Limited data exist on physician motivations for prescribing DTG 2DRs in clinical settings.
Purpose of the Study:
- To investigate physician-driven prescribing patterns of DTG 2DR components in US clinical practice.
- To identify the primary reasons for initiating DTG 2DRs and describe patient characteristics.
Main Methods:
- Retrospective chart review of adult HIV-1 patients in the US initiating DTG 2DR before July 31, 2017.
- Follow-up data collected until January 30, 2018.
- Descriptive analyses of demographics, clinical characteristics, and treatment outcomes.
Main Results:
- 278 patients received DTG 2DR, predominantly treatment-experienced individuals (98%).
- Common reasons for initiation included treatment simplification (30%) and avoiding long-term toxicities (20%).
- High rates of virologic suppression were observed: 95% in already suppressed patients and 79% in those with detectable viral load pre-treatment.
Conclusions:
- Before single-tablet 2DR availability, DTG 2DR components were utilized in treatment-experienced patients for simplification and toxicity mitigation.
- These regimens demonstrated efficacy in achieving and maintaining virologic suppression with low discontinuation rates.
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