Tolerability of integrase inhibitors in a real-life setting

• DOI: 10.1093/jac/dkx053
• Publication Date: 2017-02-15T08:55:12Z
• Authors: Judit Peñafiel; Elisa de Lazzari; Mireia Padilla; Jhon Rojas; Ana Gonzalez-Cordon; Jose L. Blanco; Jordi Blanch; Maria A. Marcos; Montserrat Lonca; Maria Martinez-Re...; Montserrat Laguno; Amparo Tricas; Ana Rodriguez; Josep Mallolas; Jose M. Gatell; Esteban Martinez
• Keywords: Elvitegravir; Raltegravir; Discontinuation; Tolerability; Dolutegravir; Integrase inhibitor; Ritonavir

Background: Integrase inhibitors have shown better tolerability than other drugs in clinical trials, but some post-marketing data suggested potential differences among them. Aims: We compared rates and reasons for discontinuation of raltegravir-, elvitegravir- dolutegravir-based regimens a large cohort HIV-infected patients. Methods: Retrospective analysis prospectively followed including all antiretroviral-naive virologically suppressed antiretroviral-experienced patients prescribed first regimen containing raltegravir, elvitegravir or dolutegravir with at least one follow-up visit. Major outcomes were early (≤1 year) due to any reason more specifically toxicity. Incidence was calculated as number episodes per 1000 person-years. Risk factors assessed by multivariate Cox models. Results: Early discontinuations 271 (raltegravir), 168 (elvitegravir) 264 (dolutegravir) patient-years (P = 0.0821). toxicity 76 103 81 0.6792). Overall, the most common toxicities leading neuropsychiatric, osteomuscular digestive. Most frequent neuropsychiatric manifestations reported insomnia, dizziness, headache anxiety irrespective integrase inhibitor. Among toxicity, effects raltegravir 0.0046). Age (HR 1.04, 95% CI 1.02–1.07, P 0.0007) only independent risk factor Conclusions: Discontinuations tended be less elvitegravir, did not differ inhibitors. Neuropsychiatric drug dolutegravir.