The Voice of Reason

An HIV treatment regimen of dolutegravir plus abacavir-lamivudine is superior to a currently recommended combination pill, according to a phase III trial published in the New England Journal of Medicine.

In the manufacturer-conducted SINGLE study, roughly 850 treatment-naive patients were randomized to dolutegravir (an integrase inhibitor) plus abacavir-lamivudine or to efavirenz-tenofovir disoproxil fumarate-emtricitabine (EFV/TDF/FTC). After 48 weeks of treatment, the dolutegravir group had a higher percentage of patients with HIV-1 RNA levels under 50 copies per milliliter (88% vs. 81%). The number of adverse events was lower in the dolutegravir group.

In his blog HIV and ID Observations, Paul Sax writes: “Up until the SINGLE study, one could argue that EFV-based treatments — especially TDF/FTC/EFV — represented the gold standard against which all other regimens must compete. Has that now changed? I think it has.”

Abstract from the NEJM: http://www.nejm.org/doi/full/10.1056/NEJMoa1215541

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[PMID]24074642[/PMID]

Filed under: EBM, Infectious Disease, Primary Care Topics | Tagged: art, HIV |