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Published byDorothy Sims Modified over 9 years ago
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Switch to LPV/r monotherapy Pilot LPV/r M03-613 LPV/r Mono KalMo OK OK04 KALESOLO MOST HIV-NAT 077
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Design Continuation of current regimen with 2 NRTIs + (NNRTI or PI) Randomisation 1 : 1 Open-label 60 HIV+ ≥ 18 years On 2 NRTIs + (NNRTI or PI) > 6 months HIV-1 RNA 6 months CD4 cell count > 200/mm 3 N = 30 KalMo Study: Switch to LPV/r monotherapy Nunes EP, HIV Clin Trials 2009;10:368-74 KalMo W96 * 533/133 mg bid for the first 2 weeks if on NNRTI at screening Endpoints –Primary endpoint: proportion of patients with HIV-1 RNA < 80 c/mL at W96 (ITT, missing equals failure analysis) –Secondary endpoints: virologic failure (2 consecutive HIV-1 RNA > 500 c/mL), AIDS-defining illnesses, CD4, safety, adverse events LPV/r 400/100 mg bid*
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KalMo Study: Switch to LPV/r monotherapy Triple therapy N = 29 LPV/r bid monotherapy N = 30 Age, median years4039 Female31%45% Hepatitis C co-infection3%10% CD4 cell count, median/mm 3 510538 Duration of ARV treatment, median months43.440.5 PI treatment at screening37%33% NNRTI treatment at screening70%63% Discontinuation by W48, n36 Discontinuation for adverse event01 (diarrhoea) Confirmed HIV RNA elevation11 Baseline characteristics and patient disposition Nunes EP, HIV Clin Trials 2009;10:368-74 KalMo
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* Includes only patients who completed 96 weeks of follow-up without discontinuation for other reasons than virologic failure Virologic outcome Nunes EP, HIV Clin Trials 2009;10:368-74 KalMo Other outcomes KalMo Study: Switch to LPV/r monotherapy 1 virologic failure (confirmed HIV-1 RNA > 500 c/mL) in each group. No resistance mutation on genotype No difference in CD4 changes between groups GI adverse events more frequent in the monotherapy group: 24 vs 10 (p = 0.001) 5 patients in the triple therapy group underwent regimen changes due to drug-related toxicities Conclusion: switching to LPV/r monotherapy is effective, safe and well tolerated through 96 weeks ITT analysis HIV-1 RNA < 80 c/mL On-treatment analysis* 86.7 96 80 0 25 50 75 100 Triple therapyLPV/r mono %
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