Switch Study From Any Prior Antiretroviral Therapy
Key Themes:
- Broader Switch Strategy: A second companion study examined switching from any stable antiretroviral regimen to doravirine/islatravir.
- Noninferiority Results: The new combination demonstrated similar efficacy to continuing prior therapy with 90% to 95% virologic suppression.
- Resistance Analysis: Few cases of treatment failure were attributed to preexisting resistance mutations.
- Practical Considerations: Positioning of this nonnucleoside reverse transcriptase inhibitor–based combination in current treatment paradigms dominated by integrase inhibitors
Notable Insights From Dr Sharon Walmsley:
- Several virologic failures were detected, but analysis revealed these were due to preexisting mutations in patients who should not have been enrolled.
- The new combination offers an alternative to integrase inhibitor-based regimens, which currently dominate treatment guidelines.
- Clinicians will need to determine appropriate patient selection criteria, with potential advantages for those with integrase inhibitor resistance or intolerance.
- More adverse events were reported when switching to the new combination vs staying on established therapy, which is expected with any regimen change.
