J Acquir Immune Defic Syndr. 2023 Nov 10. doi: 10.1097/QAI.0000000000003337. Online ahead of print.
ABSTRACT
BACKGROUND: Doravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) with demonstrated efficacy as a third agent in treatment-naive and treatment-experienced people living with HIV (PLWH) in registration studies. However, limited real-world data are available.
METHODS: By searching electronic healthcare records, PLWH using doravirine-based regimens were selected with at least one year of follow-up after their first prescription. All stable PLWH who were switched to a doravirine-based regimen were included in the analysis. The primary outcome was the durability of a doravirine-based regimen one year after prescription. Reasons for stopping were also collected. Secondary outcomes for PLWH continuing a doravirine-based regimen after one year were routine laboratory assessment, BMI, and differences in medication costs compared with their prior cART.
RESULTS: A total of 689 patients (92% men) were included from September 2019 to August 2022: 97.7% switched to doravirine/tenofovir/lamivudine (DOR/TDF/3TC). After one year 94/689 (13.6%) PLWH stopped this therapy. The main reason for discontinuation was patient-reported adverse events in 70/689 (10.2%). Medical reasons for discontinuation included increased ALT levels in 6/689 (0.9%), decreased eGFR in 3/684 (0.4%), and precautions after diagnosis of osteoporosis in 2/689 (0.3%) patients. Virologic failure occurred in 4/689 cases (0.6%), and one case demonstrated resistance mutations. The secondary outcomes demonstrated a statistically significant increase in ALT levels and decrease in LDL-C levels. The switch to a doravirine-based regimen in the Netherlands reduced medication costs by 27%.
CONCLUSION: This study demonstrated that switching to a doravirine-based regimen, mostly DOR/TDF/3TC, was highly effective and generally well tolerated, with substantial cost savings.
PMID:37963350 | DOI:10.1097/QAI.0000000000003337
