Limited Weight Impact After Switching From Boosted Protease Inhibitors to Dolutegravir in Persons With Human Immunodeficiency Virus With High Cardiovascular Risk: A Post Hoc Analysis of the 96-Week NEAT-022 Randomized Trial
Por:
Waters, L, Assoumou, L, Gonzalez-Cordon, A, Rusconi, S, Domingo, P, Gompels, M, de Wit, S, Raffi, F, Stephan, C, Masia, M, Rockstroh, J, Katlama, C, Behrens, GMN, Moyle, G, Johnson, M, Fox, J, Stellbrink, HJ, Guaraldi, G, Florence, E, Esser, S, Gatell, JM, Pozniak, A, Martinez, E
Publicada:
1 mar 2023
Ahead of Print:
1 oct 2022
Resumen:
Background In the NEAT022 trial, virologically suppressed persons with human immunodeficiency virus (HIV) at high cardiovascular risk switching from protease inhibitors to dolutegravir either immediately (DTG-I) or after 48 weeks (DTG-D) showed noninferior virological suppression and significant lipid and cardiovascular disease risk reductions on switching to dolutegravir relative to continuing protease inhibitors. Methods In post hoc analysis, major endpoints were 48-week and 96-week weight and body mass index (BMI) changes. Factors associated with weight/BMI changes within the first 48 weeks of DTG exposure, proportion of participants by category of percentage weight change, proportions of BMI categories over time, and impact on metabolic outcomes were also assessed. Results Between May 2014 and November 2015, 204 (DTG-I) and 208 (DTG-D) participants were included. Weight significantly increased (mean, +0.810 kg DTG-I arm, and +0.979 kg DTG-D arm) in the first 48 weeks postswitch, but remained stable from 48 to 96 weeks in DTG-I arm. Switching from darunavir, White race, total to high-density lipoprotein cholesterol ratio <3.7, and normal/underweight BMI were independently associated with higher weight/BMI gains. The proportion of participants with >= 5% weight change increased similarly in both arms over time. The proportions of BMI categories, use of lipid-lowering drugs, diabetes and/or use of antidiabetic agents, and hypertension and/or use of antihypertensive agents did not change within or between arms at 48 and 96 weeks. Conclusions Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.
Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.
Filiaciones:
Waters, L:
Cent & North West London NHS Fdn Trust, Mortimer Market Ctr, London, England
Assoumou, L:
Sorbonne Univ, Inst Pierre Louis Epidemiol & Sante Publ, INSERM, Paris, France
Gonzalez-Cordon, A:
Univ Barcelona, Hosp Clin, Consorci Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas, Madrid, Spain
Rusconi, S:
Azienda Socio Sanit Terr Ovest Milanese, Unita Operat Malattie Infett, Osped Civile Legnano, Legnano, MI, Italy
Domingo, P:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas, Madrid, Spain
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Gompels, M:
North Bristol NHS Trust, Bristol, Avon, England
de Wit, S:
Ctr Hosp Univ St Pierre, Brussels, Belgium
Raffi, F:
Ctr Hosp Univ, Nantes, France
Stephan, C:
Goethe Univ, Univ Klinikum, Abt Infektionskrankheiten, Frankfurt, Germany
Masia, M:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas, Madrid, Spain
Hosp Gen Univ Elche, Alicante, Spain
Rockstroh, J:
Univ Klinikum, Bonn, Germany
Katlama, C:
Hop Univ Pitie Salpetriere, Paris, France
Behrens, GMN:
Med Hsch, Hannover, Germany
Moyle, G:
Chelsea & Westminster Hosp NHS Fdn Trust, London, England
Johnson, M:
Royal Free London NHS Fdn Trust, London, England
Fox, J:
Kings Coll London, Guys & St Thomas NHS Fdn Trust, London, England
Stellbrink, HJ:
Infektionsmed Ctr, Hamburg, Germany
Guaraldi, G:
Univ Modena & Reggio Emilia, Modena, Italy
Florence, E:
Inst Trop Geneeskunde, Antwerp, Belgium
Esser, S:
Univ Klinikum, Essen, Germany
Gatell, JM:
ViiV Healthcare, Barcelona, Spain
Pozniak, A:
Chelsea & Westminster Hosp NHS Fdn Trust, London, England
Martinez, E:
Univ Barcelona, Hosp Clin, Consorci Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas, Madrid, Spain
Green Submitted, All Open Access; Green
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