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Dual Therapy for HIV Infection: Ready for Prime Time?
Slide 1.
Dual Therapy for HIV Infection: Ready for Prime Time?
Slide 1.
Case: 48-Yr-Old Man With HIV Infection and Multiple Medical Problems
Slide 2.
Case: Laboratory Analysis
Slide 3.
Which NRTI combination would you recommend?
Slide 4.
Which other agents would you use in the regimen?
Slide 5.
Goals of Antiretroviral Therapy: UNAIDS Fasttrack Targets
Slide 6.
Rationale for Dual Therapy
Slide 7.
NRTI Sparing Regimens frequently 2D: Comparison of Guidelines
Slide 8.
A word about monotherapy
Slide 9.
Dual Therapy: Issues in study design of RCTs
Slide 10.
For which of the following 2D combos is there proven non-inferiority to 3D in ARV naive?
Slide 11.
2D demonstrating noninferiority vs 3D in well-powered ARV Naïve Trials?
Slide 12.
NEAT 001/ANRS 143: DRV/r + RAL vs. DRV/r + TDF/FTC in ARV Naïve Pts
Slide 13.
NEAT-001: Viral Suppression and Primary Endpoint
Slide 14.
RAL + DRV/r met criteria for non-inferiority
Slide 15.
GARDEL: Study Design
Slide 16.
GARDEL: Results
Slide 17.
DRV/r + MVC inferior to DRV/r + 2 NRTI in treatment naïve pts: MODERN
Slide 18.
Switch to 2D in Suppressed Patients
Slide 19.
SALT: Two-Drug Maintenance with ATV/r + 3TC
Slide 20.
SALT: Switch to ATV/r + 3TC OR 2 NRTIs after virologic suppression ≥ 6 months
Slide 21.
OLE: subjects suppressed on 2N + LPV/r > 6 mos: randomized to 3TC + LPV/r vs continuation of 3D
Slide 22.
PROBE: switch to RPV + DRV/r vs. continue 2N + PI/r in suppressed pts.
Slide 	23.
HARNESS: Two-Drug Maintenance with ATV/r + RAL vs. TDF/FTC
Slide 24.
CBV and RPV LA Nanosuspensions
Slide 25.
LATTE-1: cabotegravir + rilpivirine as maintenance therapy
Slide 26.
LATTE-1: Cabotegravir (GSK1265744) + RPV as Maintenance ART: Wk 96 Results
Slide 27.
LATTE-1 Study: Results and Conclusions
Slide 28.
LATTE-2: Cabotegravir IM + Rilpivirine IM for Long-Acting Maintenance ART
Slide 29.
LATTE-2: Maintenance Wk 32 Virologic Efficacy (ITT-Maintenance Exposed)
Slide 30.
LATTE-2: Safety data through wk 32
Slide 31.
LATTE-2: Wk 32 Pt Satisfaction With Maintenance Therapy vs Oral Induction
Slide 32.
Novel Approaches: 3TC + DOL, DOL Monotherapy
Slide 33.
Why DOL + 3TC or DOL monotherapy?
Slide 34.
PADDLE: Dolutegravir + Lamivudine in Treatment-Naive Pts
Slide 35.
PADDLE: All Pts Virologically Suppressed by Wk 8 of DOL + 3TC
Slide 36.
Slope of HIV RNA Decline in PADDLE
Slide 37.
Dolutegravir Monotherapy
Slide 38.
Cost effectiveness may be most important benefit of 2D regimens
Slide 39.
DT: Future Trials of Interest
Slide 40.
Conclusions: Potential Promise of Dual Therapy
Slide 41.
Potential Limitations and Risks of DT
Slide 42.
Thank you for your attention
Slide 43.
Acknowledgements
Slide 44.