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King EM, Tkachuk S, Tseng A. Aging on antiretrovirals: reviewing the need for pharmacologic data in elderly people with HIV. AIDS 2024; 38:1609-1616. [PMID: 38953894 PMCID: PMC11296272 DOI: 10.1097/qad.0000000000003973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Affiliation(s)
- Elizabeth Marie King
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver
- Simon Fraser University, Faculty of Health Sciences, Burnaby
- Oak Tree Clinic, BC Women's Hospital
| | - Stacey Tkachuk
- Oak Tree Clinic, BC Women's Hospital
- Faculty of Pharmaceutical Sciences, UBC, Vancouver
| | - Alice Tseng
- Immunodeficiency Clinic, Toronto General Hospital
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Gan L, Xie X, Fu Y, Yang X, Ma S, Kong L, Song C, Song Y, Ren T, Long H. Bictegravir/Emtricitabine/Tenofovir Alafenamide Versus Dolutegravir Plus Lamivudine for Switch Therapy in Patients with HIV-1 Infection: A Real-World Cohort Study. Infect Dis Ther 2023; 12:2581-2593. [PMID: 37845566 PMCID: PMC10651567 DOI: 10.1007/s40121-023-00879-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/22/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) and dolutegravir plus lamivudine (DTG + 3TC) are well tolerated and effective in clinical trials. This study aimed to evaluate the safety and efficacy of these two schemes in a real-world setting and to obtain the first dataset for switching to BIC/FTC/TAF and DTG + 3TC in a Chinese population. METHODS This retrospective single-center cohort study in China included participants who switched to DTG + 3TC or BIC/FTC/TAF between January 2020 and February 2023. The main endpoint was the proportion of participants with HIV-1 RNA levels of ≥ 50 copies/mL. Safety, tolerance, and the incidence of low-level viremia (LLV) were evaluated. RESULTS A total of 525 participants were included, 454 of whom were included in the PP analysis. At week 48, the proportions of participants with HIV-1 RNA ≥ 50 copies/mL were 4.4% (10/225) for DTG + 3TC and 6.1% (14/229) for BIC/FTC/TAF; virological efficacy did not differ significantly between the two groups. Consistent results were obtained in an intent-to-treat (ITT) analysis. The incidences of LLV were 3.6% (7/193) and 4.9% (10/206), respectively. During the study, none of the participants stopped taking drugs because of a lack of efficacy or adverse reactions. CONCLUSIONS Both regimens are well tolerated and effective for switching HIV-1 infection therapy. However, the detection of genotypic drug resistance should be considered when baseline virological non-suppression is observed.
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Affiliation(s)
- Lin Gan
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Xiaoxin Xie
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Yanhua Fu
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Xiaoyan Yang
- School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Shujing Ma
- School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Linghong Kong
- School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Chunli Song
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Yebing Song
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Tingting Ren
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Hai Long
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China.
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Real-World Effectiveness, Tolerability, and Safety of Dolutegravir/Lamivudine in Korea. Viruses 2022; 14:v14112558. [PMID: 36423167 PMCID: PMC9698877 DOI: 10.3390/v14112558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Most studies on the real-world effectiveness and safety of dolutegravir/lamivudine (DTG/3TC) have been conducted in Western countries, and Asian reports are lacking. We evaluated the effectiveness and safety of DTG/3TC in Korean adult people living with HIV (PLWH). This retrospective study was conducted from July 2020 to July 2022 at a tertiary hospital in Korea. Those who were followed up for more than 12 months were included. We analyzed the baseline characteristics, effectiveness, resistant profiles, body weights, metabolic parameters, and safety of DTG/3TC treatment in 151 PLWH, dividing them into the treatment-naïve group and the switching group. The median DTG/3TC treatment durations in the treatment-naïve and switching groups were 507.5 and 525.0 days. In the treatment-naïve group, the viral RNA titer was undetectable at 6 and 12 months in 95% of patients. In the switching group, virologic suppression was well-maintained. Meanwhile, the creatinine levels were slightly elevated in both groups compared to baseline. Five participants complained of mild side effects, such as indigestion, constipation, diarrhea, and fatigue. However, no patient stopped treatment during the follow-up period. Since there was no virological failure or serious complications observed in this study, DTG/3TC may be a good treatment option for PLWH in Korea.
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Wen H, Yin L, Wang J, Zhang L, Sun T, Xu F, Zhang M, Liu L, Zhang R, Liu X, Meng X, Xing Y, Lu H, Jiao Z, Zhang L. Population pharmacokinetics and model-informed precision dosing of lamivudine in Chinese HIV-infected patients with mild and moderate impaired renal function. Expert Rev Clin Pharmacol 2022; 15:647-655. [DOI: 10.1080/17512433.2022.2078306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Haini Wen
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Lin Yin
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jiangrong Wang
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lin Zhang
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tao Sun
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feng Xu
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, SuZhou, Jiangsu, China
| | - Minxin Zhang
- Department of Pharmacy, The 900th Hospital of Joint Logistic Support Force of PLA, Fuzhou, Fujian, China
| | - Li Liu
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Renfang Zhang
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xiaoqian Liu
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xianmin Meng
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yaru Xing
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zheng Jiao
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Lijun Zhang
- Department of Clinical Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Huang W, Chen S, Sun L, Wwang H, Qiao H. Study on the intestinal permeability of lamivudine using Caco-2 cells monolayer and Single-pass intestinal perfusion. Saudi J Biol Sci 2022; 29:2247-2252. [PMID: 35531213 PMCID: PMC9073044 DOI: 10.1016/j.sjbs.2021.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background The aim of this work is to investigate the intestinal permeability of lamivudine and explore its absorption mechanism. Method Caco-2 cells monolayer and single-pass intestinal perfusion (SPIP) were selected for the investigation of lamivudine under different conditions, such as different concentration, absorption time, bidirectional transportation, and transportation with efflux transporters inhibitor. The concentration of lamivudine both in Caco-2 cells monolayer samples and SPIP samples was detected by HPLC-UV. Then the permeability parameters were calculated. Results The established HPLC-UV method reach the requirements for detection. There is no statistically difference between absorption parameters of lamivudine both in Caco-2 cells monolayer and SPIP (P > 0.05) under different dose groups. After transportation with efflux transporters inhibitor, the efflux rate of lamivudine in three dose groups was significantly decreased from 2.67, 2.59 and 2.59 to 1.78, 1.61, and 1.81 respectively. Lamivudine exhibits an absorption mechanism of passive diffusion. Conclusion The absorption of lamivudine may be related to efflux transporters. In addition, lamivudine is a moderate-permeability drug in Biopharmaceutics Classification System.
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Affiliation(s)
- Weiyin Huang
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Shuang Chen
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Lin Sun
- Jiangsu Provincial Institute of Materia Medica, Nanjing, China
| | - Hubin Wwang
- Jiangsu Provincial Institute of Materia Medica, Nanjing, China
| | - Hongqun Qiao
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
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Olafuyi O, Parekh N, Wright J, Koenig J. Inter-ethnic differences in pharmacokinetics-is there more that unites than divides? Pharmacol Res Perspect 2021; 9:e00890. [PMID: 34725944 PMCID: PMC8561230 DOI: 10.1002/prp2.890] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/19/2021] [Indexed: 12/31/2022] Open
Abstract
Inter-ethnic variability in pharmacokinetics (PK) has been attributed to several factors ranging from genetic to environmental. It is not clear how current teaching in higher education (HE) reflects what published literature suggests on this subject. This study aims to gain insights into current knowledge about inter-ethnic differences in PK based on reports from published literature and current teaching practices in HE. A systematic literature search was conducted on PubMed and Scopus to identify suitable literature to be reviewed. Insights into inter-ethnic differences in PK teaching among educators in HE and industry were determined using a questionnaire. Thirty-one percent of the studies reviewed reported inter-ethnic differences in PK, of these, 37% of authors suggested genetic polymorphism as possible explanation for the inter-ethnic differences observed. Other factors authors proposed included diet and weight differences between ethnicities. Most respondents (80%) who taught inter-ethnic difference in PK attributed inter-ethnic differences to genetic polymorphism. While genetic polymorphism is one source of variability in PK, the teaching of genetic polymorphism is better associated with interindividual variabilities rather than inter-ethnic differences in PK as there are no genes with PK implications specific to any one ethnic group. Nongenetic factors such as diet, weight, and environmental factors, should be highlighted as potential sources of interindividual variation in the PK of drugs.
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Affiliation(s)
- Olusola Olafuyi
- Division of Physiology, Pharmacology and NeurosciencesSchool of Life SciencesUniversity of NottinghamNottinghamUK
| | - Nikita Parekh
- Department of Pharmacology and TherapeuticsKing’s College LondonLondonUK
| | - Jacob Wright
- Centre for Bioscience EducationKing’s College LondonLondonUK
| | - Jennifer Koenig
- Division of Medical Sciences & Graduate Entry MedicineSchool of MedicineUniversity of NottinghamNottinghamUK
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Thakur A, Tan SPF, Chan JCY. Physiologically-Based Pharmacokinetic Modeling to Predict the Clinical Efficacy of the Coadministration of Lopinavir and Ritonavir against SARS-CoV-2. Clin Pharmacol Ther 2020; 108:1176-1184. [PMID: 32767755 PMCID: PMC7436510 DOI: 10.1002/cpt.2014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/28/2020] [Indexed: 12/26/2022]
Abstract
Lopinavir/ritonavir, originally developed for treating HIV, is currently undergoing clinical studies for treating the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Although recent reports suggest that lopinavir exhibits in vitro efficacy against SARS‐CoV‐2, it is a highly protein‐bound drug and it remains unknown if it reaches adequate in vivo unbound (free) concentrations in lung tissue. We built a physiologically‐based pharmacokinetic model of lopinavir/ritonavir in white and Chinese populations. Our aim was to perform pharmacokinetic/pharmacodynamic correlations by comparing simulated free plasma and lung concentration values achieved using different dosing regimens of lopinavir/ritonavir with unbound half‐maximal effective concentration (EC50,unbound) and unbound effective concentration 90% values of lopinavir against SARS‐CoV‐2. The model was validated against multiple observed clinical datasets for single and repeated dosing of lopinavir/ritonavir. Predicted pharmacokinetic parameters, such as the maximum plasma concentration, area under the plasma concentration‐time profile, oral clearance, half‐life, and minimum plasma concentration at steady‐state were within two‐fold of clinical values for both populations. Using the current lopinavir/ritonavir regimen of 400/100 mg twice daily, lopinavir does not achieve sufficient free lung concentrations for efficacy against SARS‐CoV‐2. Although the Chinese population reaches greater plasma and lung concentrations as compared with whites, our simulations suggest that a significant dose increase from the current clinically used dosing regimen is necessary to reach the EC50,unbound value for both populations. Based on safety data, higher doses would likely lead to QT prolongation and gastrointestinal disorders (nausea, vomiting, and diarrhea), thus, any dose adjustment must be carefully weighed alongside these safety concerns.
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Affiliation(s)
- Aarzoo Thakur
- Innovations in Food and Chemical Safety, Agency for Science, Technology, and Research, Singapore City, Singapore.,Skin Research Institute of Singapore, Agency for Science, Technology, and Research, Singapore City, Singapore
| | - Shawn Pei Feng Tan
- Innovations in Food and Chemical Safety, Agency for Science, Technology, and Research, Singapore City, Singapore.,Skin Research Institute of Singapore, Agency for Science, Technology, and Research, Singapore City, Singapore
| | - James Chun Yip Chan
- Innovations in Food and Chemical Safety, Agency for Science, Technology, and Research, Singapore City, Singapore.,Skin Research Institute of Singapore, Agency for Science, Technology, and Research, Singapore City, Singapore.,Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology, and Research, Singapore City, Singapore
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Hernández-Pineda J, Jung-Cook HH, Katende-Kyenda NL, Galindo-Sevilla N, Domínguez-Castro M, Romo-Yañéz J, Ramírez-Ramírez A, Irles C, Figueroa-Damián R. Assessment of lamivudine, zidovudine, lopinavir, and ritonavir plasma levels in HIV-positive pregnant women: Drug monitoring application to improve patient safety. Medicine (Baltimore) 2020; 99:e20487. [PMID: 32481459 DOI: 10.1097/md.0000000000020487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Simultaneous therapeutic drug monitoring (TDM) of combination antiretroviral therapy (cART) is critical during pregnancy in order to improve clinical follow-up, monitor viral load, and patient adherence to treatment.A modified simple and fast ultra-high performance liquid chromatography coupled with tandem mass spectrometry and electrospray ionization (UPLC-ESI-MS/MS) method was developed and validated according to national and international guidelines for the simultaneous determination of lamivudine (LMV), zidovudine (ZDV), lopinavir (LPV), and ritonavir (RTV) concentrations in 100-μL plasma sample of Human Immunodeficiency Virus (HIV)-positive pregnant women. Protein precipitation using 0.1% formic acid in cold acetonitrile was used for sample preparation. The chromatographic separation was achieved with a run-time of 3.0 minutes and 3-μL injection on an ethylene bridged hybrid C18 column (2.1 μm × 50 mm, 1.7 μm), under gradient conditions using acetonitrile and formic acid (0.1%).The chromatographic method was used to analyze 10 plasma samples from 8 HIV pregnant women as a clinical patient routinely follow-up by applying TDM criteria.The protonated precursor/product ion transitions for LMV (230.18/112.08), ZDV (268.22/127.10), LPV (629.55/447.35), and RTV (721.50/296.20) were recorded in multiple-reaction-monitoring (MRM) mode. The calibration curve was linear in the range of 50-3,000, 75-4,500, 250-15,000, and 25-1,500-ng/mL for LMV, ZDV, LPV, and RTV, respectively. The range of accuracy was 97.2% to 100.1% and precision 3.4% to 12.7%. The method showed specificity and matrix effect values of < 15%. Minimum absolute recovery percentages (%CV) were 90.5 (5.4), 90.8 (5.0), 95.4 (3.5), and 93.7 (6.9), for LMV, ZDV, LPV, and RTV, respectively. Drug concentrations in patient samples had high inter-individual variability with %CV of 91.98%, 77.54%, 53.80%, and 92.16% for ZDV, LMV, LPV, and RTV, respectively. Two of the 8 patients showed no adherence due to the absence of Protease Inhibitors (PIs) levels in plasma.This technique demonstrated to be effective in therapeutic drug monitoring and is intended to be used in population pharmacokinetics specifically for HIV-positive pregnant women.
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Affiliation(s)
| | | | - Norah Lucky Katende-Kyenda
- Department of Internal Medicine and Pharmacology, Walter Sisulu University, School of Medicine, Faculty of Health Sciences, Mthatha, Eastern Cape, South Africa
| | | | | | - José Romo-Yañéz
- Coordinación de Endocrinología Ginecológica y Perinatal. Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | - Claudine Irles
- Departamento de Fisiología y Desarrollo Celular. Instituto Nacional de Perinatología
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