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Rilpivirine in the treatment of HIV infection: evidence from the ECHO and THRIVE studies

机译：Rilpivirine治疗HIV感染：ECHO和THRIVE研究的证据

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摘要

Rilpivirine (RPV) is a once-daily (qd) non-nucleoside reverse transcriptase inhibitor that was evaluated in antiretroviral treatment-naive, HIV-1-infected adults (with two nucleotide reverse transcriptase inhibitors) in two international, double-blind, double-dummy, Phase HI trials (ECHO and THRIVE). Both trials met their primary objective of demonstrating noninferior efficacy of RPV 25-mg qd versus efavirenz 600-mg qd regarding the proportion of patients with a confirmed response (viral load <50 copies/ml, intention-to-treat time-to-loss-of-virologic-response) at week 48. Pooled trial responses were 84 versus 82%, respectively. While RPV was associated with more virologic failures overall (9 vs 5%) and conveyed a greater risk of resistance-associated mutations developing, in patients with baseline viral load <100,000 copies/ml, virologic failures rates were similar (4 vs 3%). RPV was associated with fewer discontinuations due to adverse events (2 vs 7%) and a better tolerability profile, particularly regarding neurologic/psychiatric events and rash, qd RPV is a valuable option for antiretroviral treatment-naive patients, particularly those with viral load <100,000 copies/ml.
机译：Rilpivirine（RPV）是一种每日一次（qd）的非核苷类逆转录酶抑制剂，已在两名接受抗逆转录病毒治疗的未接受过HIV-1感染的成年人（含两种核苷酸逆转录酶抑制剂）中进行了两次国际双盲，双盲评估虚拟的HI期试验（ECHO和THRIVE）。两项试验均达到了其主要目标，即就已确诊的患者比例（病毒载量<50拷贝/毫升，意向治疗损失时间）证实RPV 25 mg qd与依法韦仑600 mg qd的非劣效-病毒学应答）在第48周时。汇总的试验应答分别为84％和82％。虽然RPV与更多的整体病毒学失败有关（9 vs 5％），并具有更大的耐药性突变发生风险，但是基线病毒载量<100,000拷贝/ ml的患者，病毒学失败率相似（4 vs 3％） 。 RPV与因不良事件引起的停药次数较少（2比7％）和更好的耐受性有关，尤其是在神经系统/精神病事件和皮疹方面。qdRPV对于未接受抗逆转录病毒治疗的患者，尤其是病毒载量< 100,000份/毫升。

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