Volume 23 - Number 3

DOI: 10.24875/AIDSRev.20000103

July - September 2021


Efficacy and Safety of Triple versus Dolutegravir-based Dual Therapy in Patients with HIV-1 Infection: A Meta-analysis of Randomized Controlled Trials


Yuanlu Shu, Department of Evidence-based Medicine and Clinical Center, University of South China, Huaihua, China
Chengfeng Qiu, Department of Evidence-based Medicine and Clinical Center; Department of Clinical Pharmacy; University of South China, Huaihua, China
Xiaojun Tu, Department of Evidence-based Medicine and Clinical Center, University of South China, Huaihua, China
Ziwei Deng, Department of Evidence-based Medicine and Clinical Center; Department of Clinical Pharmacy; University of South China, Huaihua, China
Ye Deng, Department of Evidence-based Medicine and Clinical Center; Department of Clinical Pharmacy; University of South China, Huaihua, China
Hongqiang Wang, Department of Evidence-based Medicine and Clinical Center; Department of Clinical Pharmacy; University of South China, Huaihua, China
Xiang Zhao, Department of Evidence-based Medicine and Clinical Center;; Department of General Practice, The First People?s Hospital of Huaihua, University of South China, Huaihua, China
Zhihua Shi, Department of Evidence-based Medicine and Clinical Center; Department of Clinical Pharmacy; University of South China, Huaihua, China
  |Full Article in PDF|   |  Supplementary data

Abstract

A new strategy of simplification therapy shown the unique benefits in clinical treatment, by reducing pill burden and avoid drug exposure. To provide more evidence for the strategy, we compared the efficacy and safety of dolutegravir (DTG)-containing simplified dual combination antiretroviral therapy (cART) and traditional triple cART for people living with HIV/AIDS. The meta-analysis of randomized controlled trials compared DTG-containing dual therapy with triple cART. The primary outcome was virologic suppression. The secondary outcomes included CD4T cell recovery, lipids change from baseline, and adverse events (AEs). A total of 7 studies, 4852 patients were eligible, 2423 (49.9%) received DTG-based simplified dual cART, and 2429 (50.1%) received triple cART. The viral suppression rate was 94.7% at 24 weeks, 93.0% at 48 weeks, and 96.6% at 96 weeks in dual cART. The viral suppression rate of dual cART was non-inferior to triple cART at 24 weeks (risk difference [RD], −0.00; 95% confidence interval [CI] −0.02-0.01), at 48 weeks (RD, −0.01; 95% CI −0.02-0.01), and at 96 weeks (RD, −0.01; 95% CI −0.02-0.00). Sub-analysis results were consistent with the overall results. With regard to other outcomes (CD4T counts, lipids, any AEs, and AEs grade ≥ 3), there was no significant statistical difference between the two regimens. DTG-based simplified dual cART was non-inferior to triple cART in terms of efficacy and safety. This finding provides strong support for current consensus guidelines recommended the dual regimen as first-line treatment.


Keywords:
Dolutegravir. Dual therapy. Meta-analysis. Efficacy. Safety.





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