Publications by authors named "Rodica van Solingen-Ristea"

Article Synopsis
  • Cabotegravir plus rilpivirine (CAB + RPV) is an effective long-acting injectable treatment for maintaining HIV-1 virologic suppression, and this analysis looked at its effects based on participants' body mass index (BMI).
  • Data was collected from various trials over periods ranging from 48 to 152 weeks, focusing on virologic outcomes, confirmed failures, and safety across different BMI categories.
  • Results showed similar efficacy and tolerability for CAB + RPV LA in both lower and higher BMI groups, with high rates of HIV-1 RNA suppression and comparable safety profiles.
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Article Synopsis
  • - The study examines the safety and outcomes of a long-acting HIV treatment regimen, Cabotegravir (CAB) + Rilpivirine (RPV), focusing on injection site reactions (ISRs) experienced by participants across several trials.
  • - Analysis of injection techniques from healthcare providers revealed that practices such as slow injection speed and bringing the medication to room temperature helped minimize discomfort for patients during the injection process.
  • - Overall, the injections showed good tolerability, with most ISRs being mild to moderate and lasting only a few days, indicating that the CAB + RPV regimen is a viable option for long-term HIV maintenance therapy.
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Background: Long-acting injectable cabotegravir and rilpivirine have demonstrated safety, acceptability, and efficacy in adults living with HIV-1. The IMPAACT 2017 study (MOCHA study) was the first to use these injectable formulations in adolescents (aged 12-17 years) living with HIV-1. Herein, we report acceptability and tolerability outcomes in cohort 1 of the study.

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Background: Combined intramuscular long-acting cabotegravir and long-acting rilpivirine constitute the first long-acting combination antiretroviral therapy (ART) regimen approved for adults with HIV. The goal of the IMPAACT 2017 study (MOCHA [More Options for Children and Adolescents]) was to assess the safety and pharmacokinetics of these drugs in adolescents.

Methods: In this phase 1/2, multicentre, open-label, non-comparative, dose-finding study, virologically suppressed adolescents (aged 12-17 years; weight ≥35 kg; BMI ≤31·5 kg/m) with HIV-1 on daily oral ART were enrolled at 15 centres in four countries (Botswana, South Africa, Thailand, and the USA).

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Objectives: Cabotegravir + rilpivirine (CAB + RPV) dosed monthly or every 2 months is the first complete long-acting (LA) regimen recommended by treatment guidelines for the maintenance of HIV-1 virological suppression. This post hoc analysis summarizes outcomes for Asian participants through week 96.

Methods: Data from Asian participants naive to CAB + RPV randomized to receive dosing every 4 weeks (Q4W) or every 8 weeks (Q8W) in the FLAIR (NCT02938520) and ATLAS-2M (NCT03299049) phase 3/3b studies were pooled.

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Article Synopsis
  • Cabotegravir plus rilpivirine is the only approved long-acting treatment for HIV-1, administered every 2 months, and the SOLAR study compares its effectiveness to daily oral therapy with bictegravir, emtricitabine, and tenofovir alafenamide.
  • This phase 3b study involved 687 participants across 118 centers in 14 countries and aimed to assess if the long-acting regimen could maintain HIV virological suppression similarly to the daily regimen.
  • The study found that 67% of participants switched to long-acting therapy, demonstrating significant interest in alternatives to daily medications for maintaining HIV suppression.
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  • The ATLAS-2M study evaluated the effectiveness and safety of cabotegravir (CAB) + rilpivirine (RPV) for maintaining HIV-1 suppression, comparing two dosing schedules: every 8 weeks (Q8W) and every 4 weeks (Q4W).
  • Results showed that both dosing regimens were effective, with 87% of participants maintaining low HIV-1 levels after 152 weeks, and Q8W dosing was confirmed to be noninferior to Q4W.
  • The study found that safety profiles were similar for both groups, with no new safety concerns, confirming CAB + RPV as a long-term treatment option for HIV-1 suppression.
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  • Limited data on the effects of cabotegravir + rilpivirine (CAB + RPV) in pregnant women living with HIV showed 25 pregnancies after exposure, with diverse outcomes including 10 live births.
  • The study involved women who had taken CAB + RPV and then transitioned to other antiretroviral medications when they became pregnant, with ongoing monitoring of drug levels post-exposure.
  • Results indicated that drug concentrations during pregnancy were comparable to those in non-pregnant women, but there was one reported case of congenital anomaly among the live births, prompting further investigation into pregnancy safety and outcomes.
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  • Physicians can request compassionate use of long-acting cabotegravir + rilpivirine for HIV-1 patients who need alternatives to standard therapy due to adherence issues.
  • Out of 35 patients, those with chronic non-adherence largely due to psychological issues showed notable improvements, with many achieving or maintaining viral suppression during the study.
  • While there were some adverse events and a few deaths reported, the overall findings suggest that long-acting therapy can be an effective option for individuals struggling with adherence to oral medications.
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Background: Switching to the 2-drug regimen dolutegravir + rilpivirine demonstrated noninferiority vs continuing a 3-drug or 4-drug current antiretroviral regimen (CAR) at week 48 and maintained high levels of virologic suppression to week 148 in the SWORD studies. We report inflammation and atherogenesis biomarkers postswitch to dolutegravir + rilpivirine.

Setting: SWORD-1: 65 centers, 13 countries; SWORD-2: 60 centers, 11 countries.

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Background: To evaluate the long-term safety and efficacy of rilpivirine (RPV), a non-nucleoside reverse transcriptase inhibitor (NNRTI), in combination with nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) in human immunodeficiency virus (HIV)-infected patients.

Methods: RPV-treated HIV-infected patients from phase 2b or 3 studies rolled-over into this phase 3, open-label study and received RPV 25 mg once daily (QD) with choice of two NRTIs. Adverse events (AEs), plasma viral load, CD4 cell count, and antiviral resistance were evaluated.

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This phase 2 study investigated long-term safety and efficacy of rilpivirine (RPV) plus two investigator-selected nucleos(t)ide reverse transcriptase inhibitors (NRTIs) in HIV-1-infected antiviral therapy-naive adolescents. Participants (≥12 to <18 years of age) were treated with RPV at 25 mg once daily (q.d.

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Article Synopsis
  • - A phase 3 study called FLAIR evaluated the effectiveness of switching HIV-1 suppressed participants from daily oral medication to long-acting intramuscular injections of cabotegravir plus rilpivirine over 124 weeks.
  • - Participants were randomly assigned to either continue with their standard oral therapy or switch to the long-acting regimen, with the option to choose a four-week oral lead-in before the first injection.
  • - Key outcomes measured included viral load levels, confirmed treatment failures, and overall safety, with results showing the non-inferiority of the new long-acting treatment compared to standard therapy.
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Background: Long-acting cabotegravir and rilpivirine administered monthly or every 2 months might address the challenges associated with daily oral antiretroviral therapy. The ATLAS-2M week 48 results showed non-inferiority of long-acting cabotegravir and rilpivirine administered every 8 weeks compared with that of every 4 weeks. In this study, we report the efficacy, safety, and tolerability results from the week 96 analysis.

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Background: In the Long-Acting Antiretroviral Treatment Enabling Trial 2 (LATTE-2) phase 2b study, long-acting (LA) injectable cabotegravir + rilpivirine dosed every 8 weeks (Q8W) or every 4 weeks (Q4W) demonstrated comparable efficacy with daily oral antiretroviral therapy (ART) through 96 weeks in ART-naive adults with human immunodeficiency virus type 1 (HIV-1). Here we report efficacy, tolerability, and safety of cabotegravir + rilpivirine LA over approximately 5 years.

Methods: After 20 weeks of oral cabotegravir + abacavir/lamivudine, participants were randomized to cabotegravir + rilpivirine LA Q8W or Q4W or continue oral ART through the 96-week maintenance period.

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Background: ATLAS (NCT02951052), a phase 3, multicenter, open-label study, demonstrated that switching to injectable cabotegravir (CAB) with rilpivirine (RPV) long-acting dosed every 4 weeks was noninferior at week (W) 48 to continuing three-drug daily oral current antiretroviral therapy (CAR). Results from the W 96 analysis are presented.

Methods And Design: Participants completing W 52 of ATLAS were given the option to withdraw, transition to ATLAS-2M (NCT03299049), or enter an Extension Phase to continue long-acting therapy (Long-acting arm) or switch from CAR to long-acting therapy (Switch arm).

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Background: Advances in HIV-1 therapeutics have led to the development of a range of daily oral treatment regimens, which share similar high efficacy rates. Consequently, more emphasis is being placed upon the individual's experience of treatment and impact on quality of life. The first long-acting injectable antiretroviral therapy for HIV-1 (long-acting cabotegravir + rilpivirine [CAB + RPV LA]) may address challenges associated with oral treatment for HIV-1, such as stigma, pill burden/fatigue, drug-food interactions, and adherence.

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Article Synopsis
  • There is a growing need for less frequent and more convenient HIV treatment options to alleviate issues like stigma and the burden of daily medication.
  • The phase 3 ATLAS and FLAIR studies demonstrated that long-acting cabotegravir and rilpivirine, given every 4 weeks, is as effective as standard daily oral therapy in maintaining viral suppression in HIV-1 patients over 48 weeks.
  • The FLAIR study reveals ongoing data and effectiveness of switching to long-acting treatments in virologically suppressed adults over a longer period of 96 weeks.
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Background: Phase 3 clinical studies showed non-inferiority of long-acting intramuscular cabotegravir and rilpivirine dosed every 4 weeks to oral antiretroviral therapy. Important phase 2 results of every 8 weeks dosing, and supportive modelling, underpin further evaluation of every 8 weeks dosing in this trial, which has the potential to offer greater convenience. Our objective was to compare the week 48 antiviral efficacy of cabotegravir plus rilpivirine long-acting dosed every 8 weeks with that of every 4 weeks dosing.

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Article Synopsis
  • - The ATLAS and FLAIR studies tested a long-acting injectable treatment (cabotegravir + rilpivirine) for HIV-1 against current daily oral regimens in adults with suppressed viral loads.
  • - After 48 weeks, the injectable treatment showed similar effectiveness in keeping HIV-1 levels low compared to the daily regimen, with noninferiority criteria met and only a small percentage experiencing treatment failure.
  • - While injection site reactions were common, overall safety profiles were comparable, indicating that monthly injections could be a viable option for managing HIV-1.
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Unlabelled:  Background and rationale. The REPLACE study (NCT01571583) investigated telaprevir-based triple therapy in patients who have recurrent genotype 1 hepatitis C virus (HCV) infection following liver transplantation and are on a stable immunosuppressant regimen of tacrolimus or cyclosporin A. Patients received telaprevir 750 mg 8-hourly with pegylated interferon 180 ?g weekly and ribavirin 600 mg daily, followed by a further 36 weeks of pegylated interferon and ribavirin alone and 24 weeks of follow-up.

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This study aimed to characterize the pharmacokinetic parameters of telaprevir (TVR) in patients with moderate and severe hepatic impairment, measure the unbound (pharmacologically active) plasma concentrations of TVR, and determine if any changes in TVR exposure were of clinical relevance. Ten patients with moderate (Child-Pugh B) hepatic impairment, 10 matched healthy control volunteers, and 4 nonmatched patients with severe (Child-Pugh C) hepatic impairment received 750 mg TVR every 8 hours for 6 days. Venous blood samples were collected at various times throughout the study.

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Objectives. TEACH (NCT00896051) was a randomized, open-label, two-arm Phase II trial to investigate the pharmacokinetic interaction between etravirine and atazanavir/ritonavir and safety and efficacy in treatment-experienced, HIV-1-infected patients. Methods.

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The effect of etravirine on cytochrome P450 (CYP) enzymes and P-glycoprotein were evaluated in two randomized, crossover trials in healthy subjects. A modified Cooperstown 5 + 1 cocktail was utilized to determine the effects of etravirine on single-dose pharmacokinetics of model CYP probes. The cocktail was administered alone, then, after a 14-day washout, etravirine 200 mg twice daily (bid) was given for 14 days with cocktail on days 1 and 14.

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Objectives: Three studies were conducted to assess the pharmacokinetics, methods of administration and ease of swallowability of etravirine tablets.

Methods: Two randomized studies in healthy adults investigated the single-dose pharmacokinetics of etravirine in various dosage strengths and the effects of dispersion in water and film-coating. A third study explored swallowability of etravirine 200-mg tablets in HIV-infected patients.

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