Examination of Noninferiority, Safety, and Tolerability of Lopinavir/ritonavir and Raltegravir Compared with Lopinavir/ritonavir and Tenofovir/ Emtricitabine in Antiretroviral-Naïve Subjects: The PROGRESS Study, 48-Week Results
Authors:
- 1 October 2011
- journal article
- research article
- Published by Taylor & Francis in HIV Research & Clinical Practice
- Vol. 12 (5) , 255-267
Abstract
Purpose: Current antiretroviral regimens recommended for treatment-naïve patients include 2 nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). The purpose of this study is to evaluate whether a new NRTI-sparing regimen may provide an alternative for persons for whom traditional regimens may not be the best option.Methods: PROGRESS is a 96-week, randomized, open-label, multicenter trial comparing the efficacy and safety of a boosted protease inhibitor (PI) and an integrase inhibitor (lopi-navir/ritonavir [LPV/r] + raltegravir [RAL]) to a boosted PI and 2 NRTIs (LPV/r + tenofovir/ emtricitabine [TDF/FTC]) in antiretroviral (ARV)-naïve HIV-1–infected adults.Results: A total of 206 subjects were randomized to receive LPV/r + RAL (n=101) or LPV/r + TDF/FTC (n=105) and analyzed for ARV efficacy using the US Food and Drug Administration time to loss of virologic response (FDA-TLOVR) algorithm. The percentage of subjects with plasma HIV-1 RNA P = .850; difference -1.6%; exact 95% CI, -12.0% to 8.8%). As the lower limit of the exact 95% CI for the difference between regimens was at or above the protocol-defined threshold of -20% (as well as the more stringent threshold of -12%), LPV/r + RAL was noninferior to LPV/r + TDF/FTC. The occurrence of treatment-related, moderate/severe adverse events was similar between treatment groups through 48 weeks of treatment.Conclusions: The HIV treatment regimen of LPV/r + RAL resulted in noninferior efficacy and comparable safety and tolerability compared with a traditional NRTI-containing regimen through 48 weeks of treatment. These results support further evaluation of the LPV/r + RAL regimen.Keywords
This publication has 8 references indexed in Scilit:
- Similar Safety and Efficacy of Once- and Twice-Daily Lopinavir/Ritonavir Tablets in Treatment-Experienced HIV-1–Infected Subjects at 48 WeeksJAIDS Journal of Acquired Immune Deficiency Syndromes, 2010
- Safety and efficacy of raltegravir-based versus efavirenz-based combination therapy in treatment-naive patients with HIV-1 infection: a multicentre, double-blind randomised controlled trialThe Lancet, 2009
- A Once-Daily Lopinavir/Ritonavir-Based Regimen Is Noninferior to Twice-Daily Dosing and Results in Similar Safety and Tolerability in Antiretroviral-Naive Subjects Through 48 WeeksJAIDS Journal of Acquired Immune Deficiency Syndromes, 2009
- Kidney tubular abnormalities in the absence of impaired glomerular function in HIV patients treated with tenofovirAIDS, 2009
- Class-Sparing Regimens for Initial Treatment of HIV-1 InfectionNew England Journal of Medicine, 2008
- Tenofovir disoproxil fumarate–emtricitabine coformulation for once-daily dual NRTI backboneExpert Review of Anti-infective Therapy, 2006
- Renal Tubular Dysfunction Associated With Tenofovir TherapyJAIDS Journal of Acquired Immune Deficiency Syndromes, 2004
- Tenofovir‐Related Nephrotoxicity in Human Immunodeficiency Virus–Infected Patients: Three Cases of Renal Failure, Fanconi Syndrome, and Nephrogenic Diabetes InsipidusClinical Infectious Diseases, 2003