Universität zu Köln

De Luca, Andrea, Pezzotti, Patrizio, Boucher, Charles, Doering, Matthias, Incardona, Francesca ORCID: 0000-0002-7386-8551, Kaiser, Rolf, Lengauer, Thomas ORCID: 0000-0003-3801-2640, Pfeifer, Nico, Schuelter, Eugen, Vandamme, Anne-Mieke, Zazzi, Maurizio and Geretti, Anna Maria (2019). Clinical use, efficacy, and durability of maraviroc for antiretroviral therapy in routine care: A European survey. PLoS One, 14 (11). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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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:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code De Luca, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Pezzotti, Patrizio UNSPECIFIED UNSPECIFIED UNSPECIFIED Boucher, Charles UNSPECIFIED UNSPECIFIED UNSPECIFIED Doering, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Incardona, Francesca UNSPECIFIED orcid.org/0000-0002-7386-8551 UNSPECIFIED Kaiser, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Lengauer, Thomas UNSPECIFIED orcid.org/0000-0003-3801-2640 UNSPECIFIED Pfeifer, Nico UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuelter, Eugen UNSPECIFIED UNSPECIFIED UNSPECIFIED Vandamme, Anne-Mieke UNSPECIFIED UNSPECIFIED UNSPECIFIED Zazzi, Maurizio UNSPECIFIED UNSPECIFIED UNSPECIFIED Geretti, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-127273
DOI:	10.1371/journal.pone.0225381
Journal or Publication Title:	PLoS One
Volume:	14
Number:	11
Date:	2019
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Faculty of Mathematics and Natural Sciences
Divisions:	Faculty of Mathematics and Natural Sciences > Department of Mathematics and Computer Science > Institute of Computer Science
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TREATMENT-EXPERIENCED PATIENTS; RITONAVIR-BOOSTED DARUNAVIR; TREATMENT-NAIVE PATIENTS; HIV-INFECTED PATIENTS; SAFETY; TROPISM; EFAVIRENZ; TRIAL; RALTEGRAVIR; PROGRESSION Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12727