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Efficacy and Safety of Triple versus Dolutegravir-based Dual Therapy in Patients with HIV-1 Infection: A Meta-analysis of Randomized Controlled Trials.
AIDS Reviews ( IF 1.9 ) Pub Date : 2021-06-03 , DOI: 10.24875/aidsrev.20000103
Yuanlu Shu 1 , Chengfeng Qiu 2 , Xiaojun Tu 1 , Ziwei Deng 2 , Ye Deng 2 , Hongqiang Wang 2 , Xiang Zhao 3 , Zhihua Shi 2
Affiliation  

A new strategy of simplification therapy shown the unique benefits in clinical treatment, by reducing pill burden and avoid drug exposure. To provide more evidence for the strategy, we compared the efficacy and safety of dolutegravir (DTG)-containing simplified dual combination antiretroviral therapy (cART) and traditional triple cART for people living with HIV/AIDS. The meta-analysis of randomized controlled trials compared DTG-containing dual therapy with triple cART. The primary outcome was virologic suppression. The secondary outcomes included CD4T cell recovery, lipids change from baseline, and adverse events (AEs). A total of 7 studies, 4852 patients were eligible, 2423 (49.9%) received DTG-based simplified dual cART, and 2429 (50.1%) received triple cART. The viral suppression rate was 94.7% at 24 weeks, 93.0% at 48 weeks, and 96.6% at 96 weeks in dual cART. The viral suppression rate of dual cART was non-inferior to triple cART at 24 weeks (risk difference [RD], -0.00; 95% confidence interval [CI] -0.02-0.01), at 48 weeks (RD, -0.01; 95% CI -0.02-0.01), and at 96 weeks (RD, -0.01; 95% CI -0.02-0.00). Sub-analysis results were consistent with the overall results. With regard to other outcomes (CD4T counts, lipids, any AEs, and AEs grade ≥ 3), there was no significant statistical difference between the two regimens. DTG-based simplified dual cART was non-inferior to triple cART in terms of efficacy and safety. This finding provides strong support for current consensus guidelines recommended the dual regimen as first-line treatment.

中文翻译:

HIV-1 感染患者的三联疗法与基于 Dolutegravir 的双重疗法的疗效和安全性:随机对照试验的荟萃分析。

一种新的简化治疗策略通过减少药丸负担和避免药物暴露,在临床治疗中显示出独特的好处。为了为该策略提供更多证据,我们比较了包含多替拉韦 (DTG) 的简化双重联合抗逆转录病毒疗法 (cART) 和传统三重 cART 对 HIV/AIDS 患者的疗效和安全性。随机对照试验的荟萃分析比较了含 DTG 的双重治疗与三重 cART。主要结果是病毒学抑制。次要结果包括 CD4T 细胞恢复、基线血脂变化和不良事件 (AE)。共有 7 项研究,4852 名患者符合条件,2423 名(49.9%)接受了基于 DTG 的简化双 cART,2429 名(50.1%)接受了三重 cART。病毒抑制率在 24 周时为 94.7%,在 48 周时为 93.0%,在 96 周时。双车 96 周时为 6%。24 周时双 cART 的病毒抑制率不劣于三重 cART(风险差异 [RD],-0.00;95% 置信区间 [CI] -0.02-0.01),48 周时(RD,-0.01;95 % CI -0.02-0.01)和第 96 周(RD,-0.01;95% CI -0.02-0.00)。子分析结果与总体结果一致。关于其他结果(CD4T 计数、血脂、任何 AE 和 AE 等级 ≥ 3),两种方案之间没有显着的统计学差异。在有效性和安全性方面,基于 DTG 的简化双 cART 不劣于三重 cART。这一发现为目前推荐的双联方案作为一线治疗的共识指南提供了强有力的支持。95% 置信区间 [CI] -0.02-0.01)、48 周(RD,-0.01;95% CI -0.02-0.01)和 96 周(RD,-0.01;95% CI -0.02-0.00)。子分析结果与总体结果一致。关于其他结果(CD4T 计数、血脂、任何 AE 和 AE 等级 ≥ 3),两种方案之间没有显着的统计学差异。在有效性和安全性方面,基于 DTG 的简化双 cART 不劣于三重 cART。这一发现为目前推荐的双联方案作为一线治疗的共识指南提供了强有力的支持。95% 置信区间 [CI] -0.02-0.01)、48 周(RD,-0.01;95% CI -0.02-0.01)和 96 周(RD,-0.01;95% CI -0.02-0.00)。子分析结果与总体结果一致。关于其他结果(CD4T 计数、血脂、任何 AE 和 AE 等级 ≥ 3),两种方案之间没有显着的统计学差异。在有效性和安全性方面,基于 DTG 的简化双 cART 不劣于三重 cART。这一发现为目前推荐的双联方案作为一线治疗的共识指南提供了强有力的支持。两种方案之间没有显着的统计学差异。在有效性和安全性方面,基于 DTG 的简化双 cART 不劣于三重 cART。这一发现为目前推荐的双联方案作为一线治疗的共识指南提供了强有力的支持。两种方案之间没有显着的统计学差异。在有效性和安全性方面,基于 DTG 的简化双 cART 不劣于三重 cART。这一发现为目前推荐的双联方案作为一线治疗的共识指南提供了强有力的支持。
更新日期:2021-06-06
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