Document Detail


Efficacy and safety of atazanavir-based highly active antiretroviral therapy in patients with virologic suppression switched from a stable, boosted or unboosted protease inhibitor treatment regimen: the SWAN Study (AI424-097) 48-week results.
MedLine Citation:
PMID:  17479947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atazanavir is a once-daily protease inhibitor (PI) for the treatment of human immunodeficiency virus (HIV) infection that has previously been studied in cohorts of treatment-naive and treatment-experienced patients. Limited data are available on the usefulness of switching from a PI-based regimen to a regimen based on a different PI, such as atazanavir, in HIV-infected patients experiencing virologic suppression but seeking regimen simplification. METHODS: The Switch to Another Protease Inhibitor (SWAN) study was a 48-week, open-label trial involving HIV-positive patients with virologic suppression who were receiving stable PI-based regimens (with or without ritonavir). Patients were randomized 2 : 1 to switch to atazanavir (400 mg per day)--or, if they were receiving tenofovir, to atazanavir-ritonavir (300/100 mg per day)--or to continue to receive their existing PI. The proportion of patients who experienced virologic rebound (defined as an HIV RNA load >or=50 copies/mL) was compared through study week 48. RESULTS: Patients either received an atazanavir-containing regimen (278 patients) or continued to receive a comparator PI-containing regimen (141 patients). The proportion of patients who experienced virologic rebound was significantly lower among those who switched to an atazanavir-containing regimen (19 [7%] of 278) than it was among those who continued to receive a comparator PI regimen (22 [16%] of 141; P=.004). Patients who switched to atazanavir therapy experienced significantly fewer total cholesterol, fasting triglyceride, and non-high density lipoprotein cholesterol elevations than did patients in the comparator PI group (P<.001); patients receiving atazanavir had comparable rates of adverse event-related discontinuation and serious adverse events. CONCLUSIONS: In patients with virologic suppression who were receiving other PIs, switching to a once-per-day regimen containing atazanavir provided better maintenance of virologic suppression (as demonstrated by significantly lower rates of virologic rebound and treatment failure than those observed with continued unmodified therapy), a comparable safety profile, and improved lipid parameters, compared with those for patients who continued their prior PI-based regimen through 48 weeks.
Authors:
Jose Gatell; Dominique Salmon-Ceron; Adriano Lazzarin; Eric Van Wijngaerden; Francisco Antunes; Clifford Leen; Andrzej Horban; Victoria Wirtz; Linda Odeshoo; Monique Van den Dungen; Claudia Gruber; Emilio Ledesma;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-04-25
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  44     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-07     Completed Date:  2007-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1484-92     Citation Subset:  IM    
Affiliation:
Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. gatell0@attglobal.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antiretroviral Therapy, Highly Active / adverse effects
Drug Administration Schedule
Female
HIV Infections / drug therapy*,  virology
HIV Protease Inhibitors / administration & dosage,  adverse effects,  therapeutic use*
Humans
Male
Middle Aged
Oligopeptides / administration & dosage,  adverse effects,  therapeutic use*
Pyridines / administration & dosage,  adverse effects,  therapeutic use*
Treatment Outcome
Viral Load
Chemical
Reg. No./Substance:
0/HIV Protease Inhibitors; 0/Oligopeptides; 0/Pyridines; 198904-31-3/atazanavir

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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