Document Detail


The SWITCHMRK studies: substitution of lopinavir/ritonavir with raltegravir in HIV-positive individuals.
MedLine Citation:
PMID:  19968507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Protease inhibitors potently suppress HIV viral load but are often associated with metabolic disturbances such as dyslipidemias and lipodystrophy. In addition to exercise, diet modification and anti-lipid therapies, one potential management strategy for HIV-positive patients with dyslipidemia is to switch any antiretrovirals that may be exacerbating the condition to more lipid-neutral drugs. The SWITCHMRK studies examined the effects of substituting lopinavir/ritonavir, a protease inhibitor known to cause dyslipidemias, with the integrase inhibitor raltegravir. Participants who switched from lopinavir/ritonavir to raltegravir experienced an improvement in cholesterol and triglycerides at 12 weeks; however, a large proportion of patients in the raltegravir arms did not maintain HIV virologic suppression at less than 50 copies/ml at week 24. Further analyses are underway to determine why more patients in the raltegravir arms experienced increased virologic failure and to determine whether switching lopinavir/ritonavir with raltegravir may be appropriate for specific subgroups of patients.
Authors:
Jennifer Cocohoba
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of anti-infective therapy     Volume:  7     ISSN:  1744-8336     ISO Abbreviation:  Expert Rev Anti Infect Ther     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-08     Completed Date:  2010-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181284     Medline TA:  Expert Rev Anti Infect Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1159-63     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, 521 Parnassus Avenue, C-152, Box 0622, San Francisco, CA 94143, USA. cocohobaj@pharmacy.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
HIV Infections / drug therapy*
HIV Protease Inhibitors / adverse effects,  therapeutic use*
Humans
Pyrimidinones / adverse effects,  therapeutic use*
Pyrrolidinones / adverse effects,  therapeutic use*
Randomized Controlled Trials as Topic
Treatment Outcome
Viral Load / drug effects
Chemical
Reg. No./Substance:
0/HIV Protease Inhibitors; 0/MK 0518; 0/Pyrimidinones; 0/Pyrrolidinones; 192725-17-0/lopinavir

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


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