Adverse events of raltegravir and dolutegravir.

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State: Public
Version: Final published version
Serval ID
serval:BIB_817F925D7859
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adverse events of raltegravir and dolutegravir.
Journal
AIDS
Author(s)
Elzi L., Erb S., Furrer H., Cavassini M., Calmy A., Vernazza P., Günthard H., Bernasconi E., Battegay M.
Working group(s)
Swiss HIV Cohort Study Group
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Publication state
Published
Issued date
24/08/2017
Peer-reviewed
Oui
Volume
31
Number
13
Pages
1853-1858
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To compare the frequency and risk factors of toxicity-related treatment discontinuations between raltegravir and dolutegravir.
Prospective cohort study.
All antiretroviral therapy (ART)-naïve and ART-experienced HIV-infected individuals from the Swiss HIV Cohort Study who initiated raltegravir or dolutegravir between 2006 and 2015 were investigated concerning treatment modification within the first year.
Of 4041 patients initiating ART containing raltegravir (n = 2091) or dolutegravir (n = 1950), 568 patients discontinued ART during the first year, corresponding to a rate of 15.5 [95% confidence interval (CI) 14.5-16.9] discontinuations per 100 patient-years. Only 10 patients on raltegravir (0.5%) and two patients on dolutegravir (0.1%) demonstrated virologic failure. The main reason for ART discontinuation was convenience expressed as patient's wish, physician's decision, or treatment simplification (n = 302). Toxicity occurred in 4.3% of patients treated with raltegravir and 3.6% with dolutegravir, respectively. In multivariable analysis, the only independent risk factor for discontinuing ART because of toxicity was female sex (hazard ratio 1.98, 95% CI 1.45-2.71, P < 0.001).Neuropsychiatric complaints were the most commonly reported toxic adverse events and more frequent in the dolutegravir (n = 33, 1.7%) compared with the raltegravir group (n = 13, 0.6%). Risk of discontinuation for neurotoxicity was lower for raltegravir than for dolutegravir in multivariable analysis (hazard ratio 0.46, 95% CI 0.22-0.96, P = 0.037).
In this, large cohort raltegravir and dolutegravir-containing regimen demonstrated a high virologic efficacy. Drug toxicity was infrequent and discontinuation because of neuropsychiatric events within the first year of treatment was only marginal higher with dolutegravir compared with raltegravir. However, monitoring of neurotoxic side-effects of dolutegravir is important.

Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Anti-HIV Agents/administration & dosage, Anti-HIV Agents/adverse effects, Drug-Related Side Effects and Adverse Reactions/epidemiology, Female, HIV Infections/drug therapy, Heterocyclic Compounds, 3-Ring/administration & dosage, Heterocyclic Compounds, 3-Ring/adverse effects, Humans, Male, Mental Disorders/chemically induced, Mental Disorders/epidemiology, Middle Aged, Prospective Studies, Raltegravir Potassium/administration & dosage, Raltegravir Potassium/adverse effects, Switzerland, Withholding Treatment, Young Adult
Pubmed
Web of science
Create date
07/08/2017 10:10
Last modification date
20/08/2019 14:41
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