Dolutegravir-rilpivirine: first 2-drug regimen for HIV-positive adults

Expert Rev Anti Infect Ther. 2018 Dec;16(12):877-887. doi: 10.1080/14787210.2018.1544491. Epub 2018 Nov 14.

Abstract

New strategies for HIV treatment are being investigated to reduce drug-exposure, toxicities, and costs. Dolutegravir (DTG) 50 mg/rilpivirine (RPV) 25 mg was approved in November 2017 by FDA and in May 2018 by the European Medicines Agency (EMA). It is indicated as a complete regimen for HIV-1 infected adults with undetectable plasmatic HIV-RNA for at least 6 months on their current HIV treatment combination. Its approval was based on the data of two randomized, multicenter, non-inferiority trials (SWORD-1 and SWORD-2). Areas covered: We reviewed data from literature about DTG and RPV. We mainly focused on the efficacy and on the safety of this new dual therapy. Its impact on renal function, its bone and cardiovascular profile, its reservoir penetration and its role on inflammation were also evaluated. Expert commentary: Dual therapies may be an attractive alternative to standard triple regimens in terms of tolerability and simplicity. Long-term efficacy of DTG and RPV dual regimen need to be confirmed, where only the extensive use of this new treatment and a longer follow-up will give us the answers.

Keywords: Dolutegravir; HIV; dual-therapy; review; rilpivirine.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / adverse effects
  • Drug Approval
  • Drug Combinations
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV-1 / drug effects
  • Heterocyclic Compounds, 3-Ring / administration & dosage*
  • Heterocyclic Compounds, 3-Ring / adverse effects
  • Humans
  • Randomized Controlled Trials as Topic
  • Rilpivirine / administration & dosage*
  • Rilpivirine / adverse effects

Substances

  • Anti-HIV Agents
  • Drug Combinations
  • Heterocyclic Compounds, 3-Ring
  • dolutegravir, rilpivirine drug combination
  • Rilpivirine