HIV Alert:Новые стратегии и агенты в лечении ВИЧ/Novel Strategies and Agents for HIV Management.2017

HIV Alert: Novel Strategies and Agents for
HIV Management
This program is supported by an independent educational grant
from ViiV Healthcare

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About These Slides

Faculty
Daniel R. Kuritzkes, MD
Chief, Division of Infectious
Diseases
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts
Paul E. Sax, MD
Clinical Director
HIV Program and Division of
Infectious Diseases
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Faculty Disclosure Information
Daniel R. Kuritzkes, MD, has disclosed that he has received
consulting fees from Gilead Sciences, GlaxoSmithKline, Janssen,
Merck, and ViiV and funds for research support from Abbott, Gilead
Sciences, and Merck.
Paul E. Sax, MD, has disclosed that he has received consulting
fees from AbbVie, Bristol-Myers Squibb, Gilead Sciences,
GlaxoSmithKline/ ViiV, Janssen, and Merck and funds for research
support from Bristol-Myers Squibb, Gilead Sciences, and
GlaxoSmithKline/ViiV.

Program Overview
 Dual-Therapy Strategies
– Long-Acting Antiretroviral Therapy
 Emerging Investigational Agents
 Question and Answer Session

Why Do We Need New Options
for Patients With HIV?

0
Despite Extraordinary Efficacy, HIV Therapy Can
Be Improved
 Rates of virologic suppression can
barely be improved for adherent pts
 However, there is room to improve
ART:
– Short-term and long-term safety
– Tolerability
– Convenience
– Cost
– Activity against panresistant virus
– Still no available cure
1.0
0.8
0.6
0.4
0.2
0
ACTG A5257: All Regimens Plus TDF/FTC
for ART-Naive Pts[1]
24 48 64 80 96 120 144
RAL
DRV/RTV
ATV/RTV
ProportionofPtsWith
HIV-1RNA≤50copies/mL1. Lennox JL, et al. Ann Intern Med. 2014;161:461-471.
Wk

Key Questions With Dual-Therapy ART
Regimens
 Can these regimens be as effective as those with 3+ agents?
– If so, can the costs and toxicity of HIV treatment be reduced by
using these regimens?
 For what setting (first line, maintenance, salvage therapy) is dual
therapy best suited?
 Could investigational dual long-acting injectable therapy remove
the need for daily pills for some pts?

Previous Studies of First-line Dual-Therapy ART:
Selected Data
Study N Regimen Results
PI-Based Dual Therapy
NEAT001[1] 805 DRV/RTV + RAL
Similar efficacy as DRV/RTV + FTC/TDF; poor efficacy
in pts with high HIV-1 RNA, low CD4+ cell counts
GARDEL[2] 426 LPV/RTV + 3TC Similar efficacy as LPV/RTV + 2 NRTIs
DTG-Based Dual Therapy
PADDLE[3] 20 DTG + 3TC
18/20 pts achieved virologic suppression; n = 1
experienced PDVF (BL HIV-1 RNA > 100,000 c/mL);
resuppressed HIV-1 RNA without ART change by
discontinuation visit
1. Raffi F, et al. Lancet. 2014;384:1942-1951. 2. Cahn P, et al. EACS 2015. Abstract 961.
3. Cahn P, et al. IAC 2016. Abstract FRAB0104LB.
 ANDES and ACTG A5353 studies presented at recent IAS meeting

ANDES: DRV/RTV + 3TC vs DRV/RTV + 3TC/TDF
for ART-Naive Pts
 Randomized, open-label phase IV study in Argentina
– Planned interim analysis data reported
 Baseline: 24% HIV-1 RNA > 100,000 copies/mL
Sued O, et al. IAS 2017. Abstract MOAB0106LB.
HIV-1 RNA < 400 c/mL (ITT) at Wk 24, n/N (%) DRV/RTV + 3TC DRV/RTV + 3TC/TDF
Overall 71/75 (95) 68/70 (97)
BL HIV-1 RNA > 100,000 copies/mL 20/20 (100) 15/15 (100)
 1 virologic failure with DRV/RTV + 3TC/TDF
Interim Analysis
Wk 24
DRV/RTV + 3TC QD
(n = 75)
DRV/RTV + 3TC/TDF QD
(n = 70)
ART-naive pts with
HIV-1 RNA > 1000 copies/mL
(N = 145)
Primary Endpoint
Wk 48
Dosing: DRV/RTV, 800/100 mg; 3TC, 300 mg;
3TC/TDF, 300/300 mg.

ACTG A5353: DTG + 3TC for Treatment-Naive Pts
 Single-arm phase II study[1]
 Baseline: 31% HIV-1 RNA > 100,000 c/mL
1. Taiwo BO, et al. IAS 2017. Abstract MOAB0107LB.
2. ClinicalTrials.gov. NCT02831673. 3. ClinicalTrials.gov. NCT02831764.
Virologic
Outcome at
Wk 24, n (%)
Baseline HIV-1 RNA, copies/mL
Total
(N = 120)> 100,000
(n = 37)
≤ 100,000
(n = 83)
Success* 33 (89) 75 (90) 108 (90)
Nonsuccess 3 (8) 2 (2) 5 (4)
No data 1 (3) 6 (7) 7 (6)
 n = 3 with PDVF; n = 1 with
emergent M184V and R263R/K
mixture
– All 3 pts had DTG levels reflective
of suboptimal adherence
 GEMINI 1/2 randomized phase III
trials of DTG + 3TC ongoing[2,3]
*HIV-1 RNA < 50 copies/mL.
ART-naive pts with
HIV-1 RNA ≥ 1000 and < 500,000 copies/mL;
no RT, INSTI, major PI resistance mutations
(N = 120)
DTG 50 mg + 3TC 300 mg
Primary Endpoint
Wk 24

SWORD 1 & 2: Switch From Suppressive ART to
DTG + RPV in Pts With No Previous VF
 Randomized, open-label phase III trials in which virologically suppressed pts with no
previous virologic failure continued with baseline ART or switched to DTG + RPV
(N = 1024)[1]
– 70% to 73% of pts receiving TDF at baseline
1. Llibre JM, et al. CROI 2017. Abstract 44LB. 2. McComsey G, et al. IAS 2017. Abstract TUPDB0205LB. Slide credit: clinicaloptions.com
– 1 pt receiving DTG + RPV with confirmed
criteria for virologic withdrawal at Wk 36 had
K101K/E
– Documented nonadherence at virologic failure;
resuppressed with continued DTG + RPV
– No INSTI resistance
– AE rates generally similar between treatment
arms through Wk 52; numerically higher rate
of withdrawal for AEs with switch: 4% vs < 1%
– For pts on TDF-containing regimens at BL
(n = 102), improvements in BMD with switch[2]Virologic
Nonresponse
HIV-1 RNA
< 50 c/mL
No Data
100
80
60
40
20
0
Pts(%)
95 95
< 1 1
5 4
Treatment difference: -0.2%
(95% CI: -3.0% to 2.5%)
DTG + RPV (n = 513)
Baseline ART (n = 511)
Virologic Efficacy, Wk 48

DUAL-GESIDA: Maintenance DRV/RTV + 3TC vs
Triple DRV/RTV + 2 NRTIs
 Randomized, open-label phase IV trial in which virologically suppressed pts
continued on DRV/RTV + 2 NRTIs or switched to DRV/RTV + 3TC (N = 257)
Pulido F, et al. HIV Glasgow 2016. Abstract O331. Slide credit: clinicaloptions.com
Pts(%)
(95% CI: -11.0% to 3.4%)
Dual ART
Triple ART
Virologic
Success*
Virologic
Nonresponse
No Virologic
Data
100
80
60
40
20
0
89 93
3 2
8 6
Wk 48 Virologic Efficacy
 No resistance detected for 2 pts with
resistance data in DRV/RTV + 3TC arm
 AE rates similar between arms
 D/c for AEs: 0.8% DRV/RTV + 3TC vs
1.6% DRV/RTV + 2 NRTIs (P = .55)

DOMONO: Switch to DTG Monotherapy in
Suppressed Pts Not Sufficient
 Comparison of randomized switch to DTG 50 mg QD monotherapy vs
continued baseline ART in virologically suppressed pts with no previous
VF[1]
– At Wk 24, DTG monotherapy noninferior to continued baseline ART for
maintained HIV-1 RNA < 200 copies/mL
– Study discontinued early due to high rate of INSTI resistance mutations
after 48 wks of DTG monotherapy[2]
– VF in 8/77 pts with DTG monotherapy vs 3/152 pts on combination ART in
concurrent control group (P = .03)
– Of 8 monotherapy pts with VF, genotyping successful in 6; 3/6 with INSTI resistance
(N155H, R263K, S230R, n = 1 each)
1. Wijting I, et al. HIV Glasgow 2016. Abstract O333.
2. Wijting I, et al. CROI 2017. Abstract 451LB. Slide credit: clinicaloptions.com

Virologic
Success*
LATTE-2: Cabotegravir IM + Rilpivirine IM for
Long-Acting Maintenance ART: Wk 48 Results
 Cabotegravir: INSTI formulated as PO tablet and for long-acting IM injection
 LATTE-2: phase IIb study in which pts randomized to CAB 400 mg IM + RPV 600 mg Q4W,
CAB 600 mg IM + RPV 900 mg Q8W, or CAB 30 mg PO + ABC/3TC 600/300 mg QD after
induction/virologic suppression with PO CAB + ABC/3TC (N = 309)[1]
 PDVF, n =3 (n = 1 PO arm; n = 2 Q8W arm)
– 1 pt in Q8W group with K103N, E138G, K238T
(NNRTI) and Q148R (INSTI) resistance mutations
 99% of ISRs for pts receiving injections grade 1
(82%) or 2 (17%); none grade 4
 AEs leading to withdrawal: pooled Q4W/Q8W IM
arms, 4%; PO arm, 2%
 Phase III maintenance trials (ATLAS and FLAIR)
moving forward with Q4W dose[2,3]
References in slidenotes.
9291 89
7< 1 2 < 1
8 9
Virologic
Non-
response
No
Virologic
Data
Pts(%)
100
80
60
40
20
0
IM CAB + RPV Q4W (n = 115)
PO CAB + ABC/3TC (n = 56)
n/N =
105/
115
106/
115
50/
56

LATTE-2: 96-Wk Results for Cabotegravir IM +
Rilpivirine IM as Long-Acting Maintenance ART
 Withdrawals between Wks 48 and 96:
– CAB IM arms, n = 4 (n = 1 for AE, n =
3 withdrew consent)
– CAB PO arm, n = 3 (all withdrew
consent)
 No additional PDVFs after Wk 48 in
any arm
 ~ 88% of pts receiving IM CAB
very satisfied to continue present
treatment vs 43% receiving PO CAB
Eron J, et al. IAS 2017. Abstract MOAX0205LB. Margolis DA, et al. Lancet. 2017;[Epub ahead of print].
Virologic
Success*
94
87 84
4
0 2 2
13 14
Virologic
Nonresponse
No Virologic
Data
Pts(%)
100
80
60
40
20
0
PO CAB + ABC/3TC (n = 56)
Treatment difference (vs CAB PO):
CAB IM Q4W: 3.0%
(95% CI: -8.4% to 14.4%)
CAB IM Q8W: 10.0%
(95% CI: -0.6% to 20.5%)

Emerging Investigational Agents
and Regimens

Emerging Investigational Agents and Regimens:
Key Question
 Where might emerging investigational agents fit into the current
landscape for HIV treatment?

 Bictegravir: novel QD unboosted INSTI coformulated with FTC/TAF
 GS-1489: randomized, double-blind, active-controlled phase III trial[1]
Bictegravir/FTC/TAF vs Dolutegravir-Containing
Regimens for Treatment-Naive Pts
1. Gallant J, et al. Lancet. 2017;[Epub ahead of print]. 2. Sax PE, et al. Lancet. 2017;[Epub ahead of print].
Bictegravir/FTC/TAF*
(n = 314)
Dolutegravir/ABC/3TC†
(n = 315)
ART-naive, HLA-B*5701–negative
pts with eGFRCG ≥ 50 mL/min
(N = 629)
All pts also received placebo tablets for comparator regimen (eg, pts in GS-1489 who received BIC/FTC/TAF also received DTG/ABC/3TC
placebo). *BIC/FTC/TAF, 50/200/25 mg PO QD. †DTG/ABC/3TC, 50/600/300 mg PO QD. ‡DTG + FTC/TAF, 50 + 200/25 mg PO QD
Wk 48
 GS-1490: randomized, double-blind, active-controlled phase III trial[2]
Bictegravir/FTC/TAF*
(n = 320)
Dolutegravir + FTC/TAF‡
(n = 325)
ART-naive pts with
eGFRCG ≥ 30 mL/min
(N = 645)
Wk 48

BIC/FTC/TAF vs DTG-Containing Regimens: Key
Efficacy Findings
 No resistance for any regimen components
detected for either group
1. Gallant J, et al. Lancet. 2017;[Epub ahead of print]. 2. Sax PE, et al. Lancet. 2017;[Epub ahead of print].
 No resistance for any regimen components
detected for either group
GS-1489: Wk 48 Virologic Efficacy[1] GS-1490: Wk 48 Virologic Efficacy[2]
Pts(%)
Pts(%)
100
80
60
40
20
0
HIV-1 RNA
< 50 c/mL
HIV-1 RNA
≥ 50 c/mL
No Virologic
Data
BIC/FTC/TAF (n = 314)
DTG/ABC/3TC (n = 315)
92 93
1 3 7 4
100
80
60
40
20
0
HIV-1 RNA
< 50 c/mL
HIV-1 RNA
≥ 50 c/mL
No Virologic
Data
BIC/FTC/TAF
DTG + FTC/TAF
89 93
4 1
6
0
99 > 99
1 < 1
6
0
PP1°
(95% CI: -4.8% to 3.6%)
Treatment difference (1°): -3.5%
(95% CI: -7.9% to 1.0%)

BIC/FTC/TAF vs DTG-Containing Regimens:
Key Safety Findings
Outcome Through Wk 48
GS-1489[1,2] GS-1490[3]
BIC/FTC/TAF
(n = 314)
DTG/ABC/3TC
(n = 315)
BIC/FTC/TAF
(n = 320)
DTG + FTC/TAF
(n = 325)
Diarrhea, % 13 13 12 12
Headache, % 11 14 13 12
Nausea, % 10 23* 8 9
Upper respiratory tract infection, % 6 11 5 7
Median eGFRCG ∆ from BL, mL/min -10.5 -10.8 -7.3 -10.8†
Mean BMD ∆ from BL, % spine/hip -0.83/-0.78 -0.60/-1.02 NR NR
D/c for AE, n (%) 0 4 (1) 5 (2) 1 (< 1)
*P < .0001; †P = .02
 GS-1489: similar changes in lipids and proteinuria between groups; some pt-reported neuropsychiatric (eg, anxiety,
depression) and sleep-related symptoms (eg, disturbance) more frequent with DTG/ABC/3TC[1,2]
 No d/c for renal AEs and no proximal tubulopathy for any regimen
 Phase III trials assessing switch to BIC/FTC/TAF from DTG/ABC/3TC,[4] a boosted PI + 2 NRTIs,[5] or varied
regimens in women only[6] ongoing

 Doravirine: NNRTI with unique resistance profile, low drug–drug interaction potential
 DRIVE-FORWARD: randomized, double-blind, active-controlled phase III trial[1]
Doravirine for Treatment-Naive Pts
1. Molina JM, et al. CROI 2017. Abstract 45LB. 2. Squires KE, et al. IAS 2017. Abstract TUAB0104LB.
Doravirine + 2 NRTIs*
(n = 385)
DRV + RTV + 2 NRTIs*
(n = 384)
ART-naive pts with HIV-1 RNA
≥ 1000 copies/mL;
no resistance to study drugs
(N = 769)
All pts also received placebo tablets for comparator regimen (eg, pts in DRIVE-AHEAD who received DOR/3TC/TDF also received
EFV/FTC/TDF placebo). All dosing PO QD (see slidenotes for dosages). *2 NRTIs: FTC/TDF or ABC/3TC.
Wk 48
 DRIVE-AHEAD: randomized, double-blind, active-controlled phase III trial[2]
Doravirine/3TC/TDF
(n = 368)
EFV/FTC/TDF
(n = 366)
ART-naive pts with HIV-1 RNA
≥ 1000 copies/mL;
no resistance to study drugs
(N = 734)
Wk 48 Wk 96
Wk 96

Doravirine for Treatment-Naive Pts: Key Efficacy
Findings
 n = 1 noncompliant pt d/c at Wk 24, developed
DOR and FTC resistance
Slide credit: clinicaloptions.com1. Molina JM, et al. CROI 2017. Abstract 45LB. 2. Squires KE, et al. IAS 2017. Abstract TUAB0104LB.
0
HIV-1 RNA
< 50 c/mL
HIV-1 RNA
≥ 50 c/mL
No Data in
Window
Pts(%)
100
80
60
40
20
84 81
DOR/3TC/TDF
EFV/FTC/TDF
11 10
5
9
Treatment difference: 3.5%
(95% CI: -2.0% to 9.0%)
DRIVE-AHEAD: Wk 48 Virologic Efficacy[2]
Virologic
Nonresponse
HIV-1 RNA
< 50 c/mL
No Data
100
80
60
40
20
0
Pts(%)
84 80
11 13
5 7
(95% CI: -1.6% to 9.4%)
DOR + 2 NRTIs (n = 383)
DRV + RTV + 2 NRTIs (n = 383)
DRIVE-FORWARD: Wk 48 Virologic Efficacy[1]
 1° NNRTI resistance, n (%): DOR, 6 (1.6); EFV,
12 (3.3); no unanticipated mutations observed

Doravirine for Treatment-Naive Pts: Key Safety
Findings
AEs at Wk 48, %
DRIVE-FORWARD[1] DRIVE-AHEAD[2]
DOR
(n = 383)
DRV+RTV
(n = 383)
DOR
(n = 364)
EFV
(n = 364)
Drug-related AE 31 32 31 63*
D/c for AEs 2 3 3 7†
Neuropsychiatric 11 13 See graphic
Lipid ∆ From BL
at Wk 48, mg/dL
DOR DRV+RTV DOR EFV
LDL-C -4.51 9.92‡ -1.6 8.7‡
Non–HDL-C -5.3 13.75‡ -3.8 13.3‡
Cholesterol -1.37 17.9 -2.0 21.8
Triglycerides -3.14 21.97 -12.4 22.0
HDL-C 3.94 4.15 1.9 8.5
DRIVE-AHEAD Neuropsychiatric
Outcomes, Wk 48[2]
0
Dizziness
Pts(%)
50
30
20
10 8.8
37.1 DOR/3TC/TDF
EFV/FTC/TDF
8.2
4.1
6.6
0.3
12.1
25.5
4.4
1.1
P < .001
P < .001
P = .033
Altered
Sensorium
Depression
and
Suicide/
Self-injury
Psychosis
and
Psychotic
Disorders
Sleep
Disorders
and
Disturbances
40
 Phase III DRIVE-SHIFT trial ongoing: switch
to DOR/3TC/TDF from 2 NRTIs + third agent[3]
Difference (95% CI): *-31.9 (-38.6 to -24.8); †-3.6 (-6.9 to -0.5).
‡P < .0001.

 Randomized, open-label, active-controlled phase III trial in which virologically suppressed
pts continued a boosted PI + FTC/TDF regimen or switched to DRV/COBI/FTC/TAF
single-tablet regimen (N = 1149)[1]
(95% CI: -2.0% to 1.5%)
EMERALD: Switch From Boosted PI + FTC/TDF
to DRV/COBI/FTC/TAF in Suppressed Pts
1. Molina JM, et al. IAS 2017. Abstract TUAB0101. 2. ClinicalTrials.gov. NCT02431247.
Virologic
Rebound
 No PI or NRTI resistance associated
mutations noted (n = 2 genotyped for
each treatment group)
 Similar low rates of grade 3/4 AEs, d/c for
AEs between treatment groups
 Significant improvements in hip/spine
BMD for DRV/COBI/FTC/TAF vs control
 Ongoing phase III trial of DRV/COBI/FTC/
TAF in ART-naive pts[2]
Pts(%)
100
80
60
40
20
0
Virologic
Success
Virologic
Failure
No Virologic
Data
(95% CI: -1.7% to 3.3%)
96.3 95.5
0.5
(n = 4)
0.8
(n = 3) 3.1 3.7 1.8 2.1
DRV/COBI/FTC/TAF (n = 763)
Boosted PI + FTC/TDF (n = 378)

TMB-301: Ibalizumab in Pretreated Pts Infected
With Multidrug-Resistant HIV
 Single-arm, open-label phase III trial
– Ibalizumab: humanized mAb to CD4 receptor that blocks postattachment HIV entry into
CD4+ T-cells; FDA breakthrough and orphan drug designations
 Baseline: 53% with resistance to all drugs from ≥ 3 classes; 68% with INSTI
resistance
Lewis S, et al. CROI 2017. Abstract 449LB.
Pts with HIV-1 RNA
> 1000 copies/mL;
on ART ≥ 6 mos, on stable
ART ≥ 8 wks; resistant to ≥ 1
ARV from 3 classes, sensitive
to ≥ 1 ARV for OBR
(N = 40)
Wk 25
Ibalizumab
2000 mg IV Day 7
(Loading dose)
Continue Failing ART
Days 0-14
Ibalizumab
800 mg IV Day 21, Q2W
(Maintenance dose)
Switch to OBR
Day 14
Day 14
Primary Endpoint
Control Period:
Day 0-7

TMB-301: Key Results
 9 pts reported 17 serious AEs
– 1 drug-related serious AE (IRIS)
resulted in discontinuation
 8 other pts discontinued
 Additional phase III study ongoing[3]
1. Lalezari J, et al. IDWeek 2016. Abstract LB-6. 2. Lewis S, et al. CROI 2017. Abstract 449LB.
3. ClinicalTrials.gov. NCT02707861.
Virologic Outcome
Ibalizumab
(N = 40)
Day 14[1]
 ≥ 0.5 log10 HIV-1 RNA decrease, %* 83†
 ≥ 1.0 log10 HIV-1 RNA decrease, % 60
 Mean log10 HIV-1 RNA decrease 1.1
Wk 24[2]
 HIV-1 RNA < 50 copies/mL, % 43
 HIV-1 RNA < 200 copies/mL, % 50
 Mean HIV-1 RNA decrease from
baseline, log10
1.6
*Primary endpoint. †P < .0001 vs 3% at end of control period.

Fostemsavir vs ATV/RTV Both With RAL + TDF
for Treatment-Experienced Pts
 Fostemsavir: attachment inhibitor; binds to HIV-1 gp120
 AI438-011: randomized, active-controlled, partially blinded, dose-ranging phase IIb study of
fostemsavir vs ATV/RTV, each with RAL + TDF, for treatment-experienced pts with HIV-1 RNA
≥ 1000 copies/mL and susceptibility to study agents (N = 254)[1,2]
 Key results:
– 90% of pts in each arm had HIV-1 RNA < 50 copies/mL at Wk 96 in observed analysis
– ATV/RTV associated with higher rates of treatment-related grade 2-4 AEs (37% vs 9%) and
d/c for AEs (10% vs 3%) at Wk 96 vs fostemsavir
 Phase III trial in heavily treatment–experienced pts ongoing[3]
References in slidenotes. Slide credit: clinicaloptions.com
Wk 49
Placebo
Pts with HIV-1 RNA ≥ 400 copies/mL
on current regimen; ≤ 2 classes of active
approved ARVs left to compose OBR due to
resistance, intolerance, or contraindications Fostemsavir + OBR
Day 8*
Fostemsavir Fostemsavir + OBR
FostemsavirAs above but with no active approved ARV options remaining

Additional Emerging Investigational Agents and
Formulations (Phase II/III)
Agent MoA Phase Implications
PRO140[1-3] Humanized IgG4
CCR5 mAb
IIb/III
 Possible switch/failure strategy for pts
with R5-tropic HIV
Elsulfavirine[4] Prodrug of new
NNRTI VM1500A
IIb
 Potentially less toxic alternative to EFV
for initial ART
MK-8591[5,6] NRTTI IIb  Potential extended half-life
1. Lalezari J, et al. CROI 2017. Abstract 437. 2. ClinicalTrials.gov. NCT02859961. 3. ClinicalTrials.gov.
NCT02483078. 4. Murphy R, et al. CROI 2017. Abstract 452LB. 5. ClinicalTrials.gov. NCT03272347.
6. Matthews RP, et al. IAS 2017. Abstract TUPD0202LB. Slide credit: clinicaloptions.com

Summary
Strategy
Example
Regimens/Agents
Potential Future Implications in
HIV Treatment
Dual therapy
 DTG + 3TC or RPV
 PI/RTV + 3TC or RAL
 LA IM cabotegravir +
RPV
 Might be used in first-line, switch, induction/maintenance,
or salvage settings
 Could allow treatment simplification, cost savings,
minimization of DDIs, AEs
 DTG monotherapy not recommended
 Investigational long-acting regimens could remove need
for daily pills
Investigational
agents
 Bictegravir
 Doravirine
 DRV/COBI/FTC/TAF
 Novel agents with potential utility for
treatment-naive or switch pts
 Fostemsavir
 Ibalizumab
 Novel agents with potential utility for
treatment-experienced pts

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HIV Alert:Новые стратегии и агенты в лечении ВИЧ/Novel Strategies and Agents for HIV Management.2017

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HIV Alert:Новые стратегии и агенты в лечении ВИЧ/Novel Strategies and Agents for HIV Management.2017