De Luca, Andrea, Pezzotti, Patrizio, Boucher, Charles, Döring, Matthias, Incardona, Francesca, Kaiser, Rolf, Lengauer, Thomas, Pfeifer, Nico, Schülter, Eugen, Vandamme, Anne-Mieke et al (show 3 more authors)
(2019)
Clinical use, efficacy, and durability of maraviroc for antiretroviral therapy in routine care: A European survey.
PloS one, 14 (11).
e0225381-e0225381.
Text
Clinical use, efficacy, and durability of maraviroc for antiretroviral therapy in routine care A European survey.pdf - Published version Download (656kB) | Preview |
Abstract
OBJECTIVES:The study aimed to survey maraviroc use and assess effectiveness and durability of maraviroc-containing antiretroviral treatment (ART) in routine practice across Europe. METHODS:Data were retrieved from 26 cohorts in 8 countries comprising adults who started maraviroc in 2005-2016 and had ≥1 follow-up visit. Available V3 sequences were re-analysed centrally for tropism determination by geno2pheno[coreceptor]. Treatment failure (TF) was defined as either virological failure (viral load >50 copies/mL) or maraviroc discontinuation for any reason over 48 weeks. Predictors of TF were explored by logistic regression analysis. Time to maraviroc discontinuation was estimated by Kaplan-Meier survival analysis. RESULTS:At maraviroc initiation (baseline), among 1,381 patients, 67.1% had experienced ≥3 ART classes and 45.6% had a viral load <50 copies/mL. Maraviroc was occasionally added to the existing regimen as a single agent (7.3%) but it was more commonly introduced alongside other new agents, and was often (70.4%) used with protease inhibitors. Accompanying drugs comprised 1 (40.2%), 2 (48.6%) or ≥3 (11.2%) ART classes. Among 1,273 patients with available tropism data, 17.6% showed non-R5 virus. Non-standard maraviroc use also comprised reported once daily dosing (20.0%) and a total daily dose of 150mg (12.1%). Over 48 weeks, 41.4% of patients met the definition of TF, although the 1-year estimated retention on maraviroc was 82.1% (95% confidence interval 79.9-84.2). Among 1,010 subjects on maraviroc at week 48, the viral load was >50 copies/mL in 19.9% and >200 copies/mL in 10.7%. Independent predictors of TF comprised a low nadir CD4 count, a detectable baseline viral load, previous PI experience, non-R5 tropism, having ≥3 active drugs in the accompanying regimen, and a more recent calendar year of maraviroc initiation. CONCLUSIONS:This study reports on the largest observation cohort of patients who started maraviroc across 8 European countries. In this overall highly treatment-experienced population, with a small but appreciable subset that received maraviroc outside of standard treatment guidelines, maraviroc was safe and reasonably effective, with relatively low rates of discontinuation over 48 weeks and only 2 cases of serum transaminase elevations reported as reasons for discontinuation.
Item Type: | Article |
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Uncontrolled Keywords: | EucoHIV Study Group |
Depositing User: | Symplectic Admin |
Date Deposited: | 20 Jan 2020 09:57 |
Last Modified: | 19 Jan 2023 00:08 |
DOI: | 10.1371/journal.pone.0225381 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3071009 |