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. 2024 Sep;56(3):395-405.
doi: 10.3947/ic.2024.0066.

Efficacy and Tollerability of INI-Based 2-Drug Regimen in Virosuppressed Persons Living with HIV: A Systematic Review and Meta-Analysis

Antonio Russo #  1 , Salvatore Martini #  1 , Mariantonietta Pisaturo  1 , Maria Grazia Palamone  1 , Maria Teresa Russo  1 , Verdiana Zollo  1 , Roberta Palladino  1 , Pierantonio Grimaldi  1 , Alberto Borghetti  2 , Giuseppe Vittorio De Socio  3 , Massimiliano Fabbiani  4 , Nicola Coppola  5
Affiliations

Efficacy and Tollerability of INI-Based 2-Drug Regimen in Virosuppressed Persons Living with HIV: A Systematic Review and Meta-Analysis

Antonio Russo et al. Infect Chemother. 2024 Sep.

Abstract

Background: The aim of this meta-analysis was to synthesize the available evidence from the literature on the efficacy and safety of integrase inhibitor-based two drug regimens compared to triple drug regimens in virosuppressed people living with HIV (PLWH) in a long-term follow-up (at 96 weeks).

Materials and methods: A systematic review and meta-analysis were conducted to evaluate the efficacy, safety, and adverse drug reactions leading to discontinuation of two drug regimens compared to triple drug regimens in virosuppressed PLWH patients at 96 weeks of follow-up. We searched MEDLINE, Google Scholar, and the Cochrane Library up to March 15, 2024, and studies were selected for eligibility based on predefined criteria. Data were extracted independently by two reviewers, and risk ratios (RRs) were calculated as the measure of association between therapy and incidence of events.

Results: Six studies were included in the analysis, both clinical trials and observational studies. The two drug regimens included cabotegravir/rilpivirine, dolutegravir/lamivudine, and dolutegravir/rilpivirine. No significant differences were observed in treatment failure (RR, 0.77; 95% confidence interval [CI], 0.53-1.13; P=0.182), virological failure (RR, 0.79; 95% CI, 0.48-1.29; P=0.341), adverse drug reactions leading to discontinuation (RR, 1.74; 95% CI, 0.73-4.17; P=0.215), or appearance of mutation (RR, 2.48; 95% CI, 0.33-18.68; P=0.379) between two drug regimen and triple drug regimen groups at 96 weeks of follow up.

Conclusion: The meta-analysis provide an overview of the available evidence and supports the use of two drug regimens as an option for simplifying treatment and improving clinical outcomes in virosuppressed PLWH.

Keywords: Efficacy; HIV; Meta-analysis; Two drug regimens; Virosuppressed.

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Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1. PRISMA Flow chart of studies included.
Figure 2
Figure 2. Forest plot of risk ratios of treatment failure in patients receiving two drug regimens or triple drug regimens.
Figure 3
Figure 3. Funnel plot of treatment failure at 96 weeks.
RR, risk ratio.
See this image and copyright information in PMC

References

    1. Mazzitelli M, Sasset L, Gardin S, Leoni D, Trunfio M, Scaglione V, Mengato D, Agostini E, Vania E, Putaggio C, Cattelan A. Real-life experience on dolutegravir and lamivudine as initial or switch therapy in a silver population living with HIV. Viruses. 2023;15:1740. - PMC - PubMed
    1. Moreno S, Perno CF, Mallon PW, Behrens G, Corbeau P, Routy JP, Darcis G. Two-drug vs. three-drug combinations for HIV-1: Do we have enough data to make the switch? HIV Med. 2019;20(Suppl 4):2–12. - PubMed
    1. Hidalgo-Tenorio C, Pasquau J, Vinuesa D, Ferra S, Terrón A, SanJoaquín I, Payeras A, Martínez OJ, López-Ruz MÁ, Omar M, de la Torre-Lima J, López-Lirola A, Palomares J, Blanco JR, Montero M, García-Vallecillos C. DOLAVI real-life study of dolutegravir plus lamivudine in naive HIV-1 patients (48 weeks) Viruses. 2022;14:524. - PMC - PubMed
    1. Pisaturo M, Onorato L, Russo A, Martini S, Chiodini P, Signoriello S, Maggi P, Coppola N. Risk of failure in dual therapy versus triple therapy in naïve HIV patients: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27:28–35. - PubMed
    1. Achhra AC, Mwasakifwa G, Amin J, Boyd MA. Efficacy and safety of contemporary dual-drug antiretroviral regimens as first-line treatment or as a simplification strategy: a systematic review and meta-analysis. Lancet HIV. 2016;3:e351–e360. - PubMed