BY DESMOND CHINGARANDE in Mexico
Scientists attending the 10th International Aids Society conference on HIV Science yesterday availed a new and more efficient drug and novel remedy regimens in anti-retro-viral therapy that have potential to change the treatment of the deadly disease.
The evidence released yesterday presented the safety and efficiency of moving from three to two drug regimens therapy for people starting treatment for the first time and for people who switch after being virally suppressed on another regimen.
Addressing the media, IAS President and IAS 2019 International Scientific chair Anton Pozniak said the treatment regimens have the potential to improve long term tolerability and reduce costs and pill sizes.
“New drugs and novel treatment regimens have the potential to improve long-term tolerability and reduce costs and pill sizes. We have new drugs with new mechanisms of action and important data from a trial looking at Dolutegravir (DTG) and TAF in resource-limited settings, the advances we are seeing in science are about giving people living with HIV more choices,” Pozniack said.
The Scientists presented two studies on the safety and efficacy of DTG plus Lamivudine (3TC) in two-drug therapies for people starting treatment for the first time and for people who switch after being virally suppressed on another regimen.
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The first analysis reviewed two identically designed clinical trials involving 1 400 patients, known as GEMINI 1 and 2 and these randomised, Phase III trials compared the safety and efficacy of DTG and 3TC in patients who were HIV naive with those taking the three-drug combination of DTG, Tenofovir and Emtricitabine.
This new analysis includes 96 weeks of data and it shows that the two-drug regimen remains non-inferior to the three-drug regimen over the two-year period of the study. A new HIV treatment drug promising is the MK-8591, the first drug in a new class of treatments known as nucleoside transcriptase translocation inhibitors (NRTTIs).
The authors presented 48-week data from a Phase 2B, randomised trial in which MK-8591 was used as part of first-line therapy.
The study included 121 patients randomised to one of four study arms. In three of them, patients received different doses of MK-8591 together with 3TC plus Doravirine, a new-generation non-nucleoside reverse transcriptase inhibitors, for at least the first 24 weeks.
After 24 weeks, patients in these arms who were virally suppressed switched to a two-drug combination of MK-8591 and Doravirine.
This study provides another promising sign — not only of the benefits of a new treatment, but also of the potential for a two-drug regimen.
Scientists also focused on analysis reducing the number of pills that a person living with HIV must take. Specifically, this open-label, randomised Phase III study compared the use of typical three-drug regimens taken four days per week with daily use.
The study, conducted in France by ANRS, included more than 600 participants randomised to the two approaches.
They were taking a range of three-drug regimens, and all had been virally suppressed for more than 12 months.
After 48 weeks of treatment, the four-days-per-week approach was found to be non-inferior to everyday treatment, in terms of maintaining viral suppression.
The scientists concluded that these findings offer further evidence that newer HIV treatment drugs can be used in innovative ways.