This article is more than 5 years old. Information may no longer be current.
Once-daily raltegravir tolerated, effective among injection drug users
Click Here to Manage Email Alerts
Among injection drug users, once-daily raltegravir was well tolerated, effective and associated with a high degree of adherence, according to study results presented at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy.
Kris Stewart, BSPharm, MD, FRCPC, of the University of Saskatchewan in Saskatoon, Canada, and colleagues studied the drug among injection drug users with HIV. According to background information, injection drug users require drug regimens that maximize adherence. Raltegravir (Isentress, Merck) had previously demonstrated inferiority when given once a day.
Kris Stewart
“Although once-daily raltegravir is less potent than twice-daily raltegravir, which is double the dose, once-daily dosing allows one to use it in a directly observed therapy (DOT) program, which dramatically improves adherence and leads to favourable outcomes,” Stewart told Infectious Disease News. “In patients that struggle with adherence, such as illicit drug users, using once-daily raltegravir is an effective option.”
Stewart and colleagues evaluated 150 injection drug users who attended inner-city clinics in Vancouver. They were receiving regimens that included once-daily raltegravir, typically within a directly observed treatment program. Virologic suppression, immune recovery, toxicity and treatment changes were evaluated.
In 85% of the participants, DOT programs were in place. At baseline, the median CD4 count was 350 cells/mm3 and the median HIV plasma viral load was 28,500 copies/mL. Within a 6- to 18-month follow-up period, 80% of the patients had maximal virologic suppression. Among 10% of patients, virologic breakthrough occurred, but within 3 months, all patients reached resuppression.
The median adherence to therapy was 90%. There was no incidence of resistance to raltegravir, and there were no cases of toxicity leading to drug discontinuation.
“Raltegravir has a better tolerability profile and fewer drug interactions than many other antiretroviral therapies, making it a desirable drug to use in our patients,” Stewart said. “Raltegravir also does not interact significantly with treatments for hepatitis C. In patients that can only be reliably treated in a once daily DOT model, as is the case for many injection drug users, our results provide evidence that raltegravir is a suitable choice. This has the potential to significantly increase the number of patients eligible for treatment, which may mean the difference in some individuals between living well with an undetectable viral load or dying from the complications of AIDS.”
For more information:
Stewart K. #H-884. Presented at: 52nd ICAAC; Sept. 9-12, 2012; San Francisco.
Disclosure: The researchers report no relevant financial disclosures.