1
|
Tiraboschi J, Prieto P, Saumoy M, Silva A, Imaz A, Scevola S, Fernandez G, Navarro A, Piatti C, Podzamczer D. Short term Neuropsychiatric and Body Weight Changes in Patients Switching from EVG/Cobi/FTC/TAF to BIC/FTC/TAF (PreEC/RIS69). Curr HIV Res 2022; 20:251-254. [PMID: 35676852 DOI: 10.2174/1570162x20666220608160335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/28/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND NP, clinical and laboratory changes have been reported in patients switching from EVG/Cobi/FTC/TAF to BIC/FTC/TAF in clinical practice. METHODS A group of subjects switching from EVG/Cobi/FTC/TAF to BIC/F/TAF was prospectively followed. A validated sleep quality questionnaire (Pittsburgh Sleep Quality Index), as well as the Hospital Anxiety and Depression Scale (HADS), were administered after 4 weeks from treatment switch. Adverse events, side effects and discontinuation, were recorded at week 4 and 24. Pre-treatment switch and week 24 body weight and laboratory data were compared. RESULTS A total of 96 virologically suppressed patients (86% male) were included. All patients received EVG/Cobi/FTC/TAF at least 1 year before the treatment switch. Median (IQR) nadir CD4 was 367 (263). The most common comorbidities were dyslipidemia, HTA and diabetes, 26%; 14% and 7%, respectively. Depression was reported by 8%. Five patients discontinued BIC/FTC/TAF before week 4 due to intolerance (2 insomnia, 1 headache and 2 GI symptoms). No changes in sleep quality, anxiety and depression outcomes were observed at week 4 (p=0.1, p=0.1 and p=0.3, respectively). After 6 months, median body weight change was statistically significant (0.6 kg, p=0.003). All patients maintained HIV suppression. CONCLUSIONS Except in few cases, sleep quality, anxiety and depression symptoms remain stable in HIV virologically suppressed patients on EVG/Cobi/FTC/TAF who switch to BIC/F/TAF. NPAEs are mild and tend to occur in those with previous neuropsychiatric symptoms. Weight gain tends to be small but statistically significant. Long-term follow-up in "real life" cohorts would be needed to confirm these findings.
Collapse
Affiliation(s)
- Juan Tiraboschi
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Paula Prieto
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Maria Saumoy
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Ana Silva
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Arkaitz Imaz
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Sofía Scevola
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Guillem Fernandez
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Antonio Navarro
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Camila Piatti
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| | - Daniel Podzamczer
- Infectious Disease Service. Hospital Universitari de Bellvitge-IDIBELL. Universitat de Barcelona. L'Hospitalet de Llobregat, Barcelona. Spain
| |
Collapse
|
2
|
Imaz A, Tiraboschi JM, Niubó J, Martinez-Picado J, Cottrell ML, Domingo P, Chivite I, Negredo E, Schauer A, Van Horne B, Morenilla S, Urrea V, Silva-Klug A, Scevola S, Garcia B, Kashuba ADM, Podzamczer D. Dynamics of the decay of HIV RNA and distribution of bictegravir in the genital tract and rectum in antiretroviral-naïve HIV-1-infected adults treated with bictegravir/emtricitabine/tenofovir alafenamide (Spanish HIV/AIDS Research Network, PreEC/RIS 58). Clin Infect Dis 2020; 73:e1991-e1999. [PMID: 32945851 DOI: 10.1093/cid/ciaa1416] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The pharmacokinetics of bictegravir and its association with decay of HIV-1 RNA in genital fluids and the rectum have not yet been addressed. METHODS Prospective multicenter study of HIV-1-infected, antiretroviral-naive individuals initiating BIC/FTC/TAF. HIV-1 RNA was measured (LOQ 40 copies/mL) in blood plasma (BP), seminal plasma (SP), rectal fluid (RF), and cervicovaginal fluid (CVF) at baseline, at days 3, 7, 14, and 28, and at weeks 12 and 24. Total and protein-unbound bictegravir concentrations were quantified in BP, SP, CVF and rectal tissue (RT) at 24 hours postdose (C24h) on day 28 and week 12 using a validated LC-MS/MS assay. RESULTS The study population comprised 15 males and 8 females. In SP, RF, and CVF, baseline HIV-1 RNA was >40 copies/mL in 12/15, 13/15, and 4/8 individuals, with a median of 3.54 (2.41-3.79), 4.19 (2.98-4.70), and 2.56 (1.61-3.56) log10 copies/mL, respectively. The initial decay slope was significantly lower in SP than in RF and BP. Time to undetectable HIV-1 RNA was significantly shorter in SP and RF than in BP. All women achieved undetectable HIV-1 RNA in CVF at day 14.The median total bictegravir concentrations in SP, RT, and CVF were 65.5 (20.1-923) ng/mL, 74.1 (6.0-478.5) ng/g, and 61.6 (14.4-1760.2) ng/mL, representing 2.7%, 2.6%, and 28% of the BP concentration, while protein-unbound fractions were 51.1%, 44.6%, and 42.6%, respectively. CONCLUSIONS BIC/FTC/TAF led to rapid decay of HIV-1 RNA in genital and rectal fluids. Protein-unbound bictegravir concentrations in SP, RT, and CVF highly exceeded the EC50 value (1.1 ng/mL).
Collapse
Affiliation(s)
- Arkaitz Imaz
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan M Tiraboschi
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Niubó
- Department of Microbiology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Martinez-Picado
- IrsiCaixa AIDS Research Institute, Badalona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Mackenzie L Cottrell
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Pere Domingo
- Department of Infectious Diseases, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Ivan Chivite
- Department of Internal Medicine, Sant Joan Despí Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
| | - Eugenia Negredo
- Lluita Contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - Amanda Schauer
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian Van Horne
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sandra Morenilla
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Urrea
- IrsiCaixa AIDS Research Institute, Badalona, Spain
| | - Ana Silva-Klug
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sofía Scevola
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Benito Garcia
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Angela D M Kashuba
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel Podzamczer
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
4
|
Gennari R, Rotmensz N, Ballardini B, Scevola S, Perego E, Zanini V, Costa A. A prospective, randomized, controlled clinical trial of tissue adhesive (2-octylcyanoacrylate) versus standard wound closure in breast surgery. Surgery 2004; 136:593-9. [PMID: 15349107 DOI: 10.1016/j.surg.2004.02.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations and incisional surgical wounds leads to cosmetic outcome comparable to conventional sutures. To date, no studies have investigated tissue adhesive in breast surgery and costs. Our aim was to compare the tissue adhesive 2-octylcyanoacrylate (OCA) with standard suture in breast surgery. METHODS A prospective randomized study was conducted in which 151 patients were assessed for eligibility, and 133 were randomly allocated to skin closure with OCA adhesive or monofilament suture. Cosmetic outcome with blinded assessment, wound management by the patients, complication rates, and economic outcome were recorded. RESULTS There was no difference in cosmetic score in the 2 groups, nor in complications at the early, 6-month, and 1-year follow-up. Patient satisfaction with the wound closed with OCA was rated significantly higher when compared with standard suture (P <.0001). The application of the tissue adhesive was significantly faster than that for standard suture (P <.001). In economic terms total costs were less in the tissue adhesive group, mainly due to lower postoperative costs of physician and assistant services (P <.001). CONCLUSIONS OCA is effective and reliable in skin closure for breast surgery, yielding similar cosmetic results to standard suture. OCA is faster than standard wound closure and offers several practical advantages over suture repair for patients. Cost analysis has found that OCA adhesive can significantly decrease health care costs.
Collapse
Affiliation(s)
- R Gennari
- Department of Surgery, European Institute of Oncology, Milano, Italy
| | | | | | | | | | | | | |
Collapse
|