7th International AIDS Society Conference, Kuala Lumpur, June 2013:
The new integrase inhibitor dolutegravir showed better suppression of HIV at 48 weeks than raltegravir (Isentress). Other benefits from taking the once-a-day pill included fewer people who had uncontrolled HIV and who had developed drug resistance.
The Argentinian SAILING study included 724 people who were on a failing regimen with a detectable viral load. Everyone showed resistance to two or more classes of HIV treatment, except for integrase inhibitors. Average CD4 count was near 200 and one-third of them had viral load above 50,000.
Half took dolutegravir while the other half took raltegravir, together with no more than two other drugs, at least one of which was still fully active. By week 48, CD4 counts increased about the same between the two groups: 162 (dolutegravir) vs. 153 (raltegravir).
Also, 71% of those on dolutegravir had undetectable viral load compared to 64% on raltegravir (statistically significant). For those who started with viral loads below 50,000, 75% on dolutegravir and 71% on raltegravir were undetectable at 48 weeks (not statistically significant). However, for those who started their regimen with viral loads above 50,000, 62% of those on dolutegravir were undetectable compared to 47% on raltegravir (statistically significant).
Only 1% on dolutegravir developed new integrase inhibitor mutations while 5% did on raltegravir. Both drugs were well tolerated in this study, and very few severe lab abnormalities were reported for either drug.
ABSTRACT
P Cahn, A Pozniak, H Mingrone, et al. Dolutegravir (DTG) is superior to raltegravir (RAL) in ART-experienced, integrase naive subjects: week 48 results from SAILING (ING111762). 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Kuala Lumpur, June 30-July 3, 2013.
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