A more favourable safety profile with respect to
gastrointestinal AEs and lipid-related parameters was observed at 48 and 96 weeks with DRV/r vs. LPV/r [6, 7]. The findings at 96 weeks also supported the week 48 analysis in that no emergence of major (primary) protease inhibitor (PI) mutations or loss of phenotypic PI susceptibility was observed after virological failure (VF) in either treatment arm [6-8]. The final, week 192 efficacy and safety analysis of the ARTEMIS trial is presented in this paper. The objective was to provide longer-term follow-up of initial therapy with DRV/r 800/100 mg once daily and, in particular, to evaluate the durability of the virological response and how this
may relate to the development of resistance. Dinaciclib In addition, the analysis provides an evaluation of the longer-term safety and tolerability profile of DRV/r over 4 years. The detailed methodology this website of ARTEMIS has been previously reported . In brief, the trial included a screening period of 2–4 weeks followed by 192 weeks of treatment. At screening, treatment-naïve patients were stratified according to plasma HIV-1 RNA (< 100 000 or ≥ 100 000 copies/mL) and CD4 cell count (< 200 or ≥ 200 cells/μL). Patients were then randomized (1:1) to receive either DRV/r 800/100 mg once daily or LPV/r 800/200 mg total daily dose (once or twice daily) using a predefined randomization list. LPV/r 800/200 mg once daily could be used in those countries where the once-daily use of LPV/r was approved. In those countries where once-daily use was not approved, patients received LPV/r 400/100 mg twice daily. LPV/r was taken as either a capsule or a tablet; those patients who began therapy on capsules were switched to tablets later in the course of the study, subject to
availability and local approval. All patients received a fixed-dose background regimen of Truvada® Clomifene (Gilead Sciences, Foster City, CA, USA) [tenofovir (TDF) 300 mg once daily plus emtricitabine (FTC) 200 mg once daily]. The primary objective of the trial was to demonstrate noninferiority of DRV/r 800/100 mg once daily vs. LPV/r 800/200 mg in the proportion of patients with HIV-1 RNA < 50 copies/mL at week 48 (ITT-TLOVR). Secondary objectives of the trial were to evaluate the durability of virological response over 192 weeks and the statistical superiority of DRV/r to LPV/r in virological response should noninferiority be established. Other secondary objectives included evaluating long-term safety and tolerability, and evaluating change from baseline in HIV-1 RNA levels and CD4 cell counts. Detailed inclusion and exclusion criteria have been reported previously . Main inclusion criteria were treatment-naïve, HIV-1-infected adults aged ≥ 18 years with plasma HIV-1 RNA ≥ 5000 copies/mL.