TY - JOUR
T1 - Limited weight impact after switching from boosted protease inhibitors to dolutegravir in persons with human immunodeficiency virus with high cardiovascular risk: a post hoc analysis of the 96-week NEAT-022 randomized trial
AU - NEAT 022 Study Grp
AU - Waters, Laura
AU - Assoumou, Lambert
AU - Gonzalez-Cordon, Ana
AU - Rusconi, Stefano
AU - Domingo, Pere
AU - Gompels, Mark
AU - de Wit, Stephane
AU - Raffi, Francois
AU - Stephan, Christoph
AU - Masia, Mar
AU - Rockstroh, Jurgen
AU - Katlama, Christine
AU - Behrens, Georg M. N.
AU - Moyle, Graeme
AU - Johnson, Margaret
AU - Fox, Julie
AU - Stellbrink, Hans-Jurgen
AU - Guaraldi, Giovanni
AU - Florence, Eric
AU - Esser, Stefan
AU - Gatell, Jose M.
AU - Pozniak, Anton
AU - Martinez, Esteban
N1 - NPP
PY - 2023
Y1 - 2023
N2 - Background In the NEAT022 trial, virologically suppressed persons with human immunodeficiency virus (HIV) at high cardiovascular risk switching from protease inhibitors to dolutegravir either immediately (DTG-I) or after 48 weeks (DTG-D) showed noninferior virological suppression and significant lipid and cardiovascular disease risk reductions on switching to dolutegravir relative to continuing protease inhibitors. Methods In post hoc analysis, major endpoints were 48-week and 96-week weight and body mass index (BMI) changes. Factors associated with weight/BMI changes within the first 48 weeks of DTG exposure, proportion of participants by category of percentage weight change, proportions of BMI categories over time, and impact on metabolic outcomes were also assessed. Results Between May 2014 and November 2015, 204 (DTG-I) and 208 (DTG-D) participants were included. Weight significantly increased (mean, +0.810 kg DTG-I arm, and +0.979 kg DTG-D arm) in the first 48 weeks postswitch, but remained stable from 48 to 96 weeks in DTG-I arm. Switching from darunavir, White race, total to high-density lipoprotein cholesterol ratio = 5% weight change increased similarly in both arms over time. The proportions of BMI categories, use of lipid-lowering drugs, diabetes and/or use of antidiabetic agents, and hypertension and/or use of antihypertensive agents did not change within or between arms at 48 and 96 weeks. Conclusions Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.
AB - Background In the NEAT022 trial, virologically suppressed persons with human immunodeficiency virus (HIV) at high cardiovascular risk switching from protease inhibitors to dolutegravir either immediately (DTG-I) or after 48 weeks (DTG-D) showed noninferior virological suppression and significant lipid and cardiovascular disease risk reductions on switching to dolutegravir relative to continuing protease inhibitors. Methods In post hoc analysis, major endpoints were 48-week and 96-week weight and body mass index (BMI) changes. Factors associated with weight/BMI changes within the first 48 weeks of DTG exposure, proportion of participants by category of percentage weight change, proportions of BMI categories over time, and impact on metabolic outcomes were also assessed. Results Between May 2014 and November 2015, 204 (DTG-I) and 208 (DTG-D) participants were included. Weight significantly increased (mean, +0.810 kg DTG-I arm, and +0.979 kg DTG-D arm) in the first 48 weeks postswitch, but remained stable from 48 to 96 weeks in DTG-I arm. Switching from darunavir, White race, total to high-density lipoprotein cholesterol ratio = 5% weight change increased similarly in both arms over time. The proportions of BMI categories, use of lipid-lowering drugs, diabetes and/or use of antidiabetic agents, and hypertension and/or use of antihypertensive agents did not change within or between arms at 48 and 96 weeks. Conclusions Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.
KW - weight
KW - switch
KW - dolutegravir
KW - TENOFOVIR DISOPROXIL FUMARATE
KW - BODY-MASS
KW - GAIN
KW - RITONAVIR
KW - RALTEGRAVIR
KW - ATAZANAVIR
UR - https://www.webofscience.com/wos/woscc/full-record/WOS:000878301600001
U2 - 10.1093/cid/ciac827
DO - 10.1093/cid/ciac827
M3 - A1: Web of Science-article
SN - 1058-4838
VL - 76
SP - 861
EP - 870
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
M1 - ciac827
ER -