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Short Communication: Maraviroc Once-Daily: Experience in Routine Clinical Practice

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摘要

To assess the efficacy and safety of maraviroc (MVC) administered once-daily in routine clinical practice. A retrospective multicenter study (27 centers in Spain) was conducted. Data were collected from the records of patients starting a regimen with MVC. Laboratory and clinical data were recorded every 3 months the first year and every 6 months thereafter. Data are presented as median and interquartile range. Among 667 patients treated with MVC, 142 (21.3) received MVC once-daily: 108 (76.1), 150mg and 34 (23.9), and 300 mg. Age was 47 (42-45) years, there were 76.1 men, and 81 (57) patients had baseline HIV-RNA < 50 copies/mL. Viral tropism was R5 in 118 (83.1) patients. Reasons for prescribing MVC: salvage therapy (36.6), drug toxicity (31.2), simplification (16.9), and immunodiscordant response (7.1). Median follow-up was 13 (9-16) months. In 95.8, a PI/r was part of the regimen (67 on dual therapy). At months 12 and 24, 73.3 and 68.2 of patients had HIV-RNA < 50 copies/mL, respectively (p=.041 and p<.001 vs. baseline). CD4(+) cell count increased by a median of 52 (-36,135) and 84 (-9.5,180) cells/mm 3 at 12 and 24 months, respectively (p<.001 and p =.039 vs. baseline). Twenty-five (17.6) patients discontinued MVC: virologic failure (6), medical decision (5), and other reasons (14). Two patients presented grade 3 adverse events (hypertransaminasemia, hypertriglyceridemia) without the need for MVC withdrawal, whereas MVC was discontinued in two patients due to gastrointestinal toxicity. In routine clinical practice, MVC once-daily combined with at least PI/r was virologically effective and well tolerated in a high percentage of pretreated patients.

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