4CPS-080 Optimisation of antiretroviral therapy: results after simplification to bitherapy with dolutegravir/lamivudine or dolutegravir/rilpivirine

• Published in: European journal of hospital pharmacy. Science and practice Vol. 30; no. Suppl 1; pp. A187 - A188
• Main Authors: Canalejo Fuentes, MJ, Herrero Muñoz, N, Ontañón Nasarre, A, García Gil, M
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 01.03.2023; BMJ Publishing Group LTD
• Subjects: Conflicts of interest; Drug therapy; Economic impact; HIV; Human immunodeficiency virus; Late breaking abstracts
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.389

Background and ImportanceSimplification of antiretroviral therapy with dolutegravir/lamivudine (DTG/3TC) or dolutegravir/rilpivirine (DTG/RPV) improves the safety profile and cost-effectiveness of treatment in patients with human immunodeficiency virus (HIV).Aim and ObjectivesTo evaluate the efficiency of simplification to bitherapy with DTG/3TC or with DTG/RPV in patients with HIV.Material and MethodsObservational, retrospective study, carried out in a second-level hospital from July 2019 to March 2022. All patients diagnosed with HIV who simplified antiretroviral treatment to bitherapy with DTG/3TC or DTG/RPV were included.The main variables studied were the percentage of patients with undetectable viral load (viral load <50 copies/mL) measured in the first analytical determination performed after treatment simplification and the economic impact of this simplification.Other variables recorded were age, sex, viral load prior to treatment simplification, and type of bitherapy received.The data was obtained from the electronic medical record and the pharmacy dispensing program.Statistical data analysis was performed using descriptive frequency analysis.For the analysis of the economic impact, the difference between the annual consumption of each patient in treatment with triple therapy and with bitherapy was calculated.Results415 patients receiving antiretroviral treatment were in follow-up in our centre. Treatment simplification was performed on 154 patients (37.10%). 76.62% (118/154) were men. The median age was 45 years (22–87). Before the change in treatment, 98.7% (152/154) of patients had undetectable viral load. 96.1% (148/154) of patients had a new viral load determination after treatment simplification. This determination was made with a median follow-up of 5.33 months (1.5–12.76). Of these, 100% (148/148) of patients maintained undetectable viral load.In 94.81% (146/154) of patients, treatment was simplified to DTG/3TC and in 5.19% (8/154) to DTG/RPV.The economic impact of the simplification of treatment to bitherapy for 154 patients implies a saving of €198,842.62/year (€179,352.64/year with simplification to DTG/3TC of 146 patients and €19,489.98/year with simplification to DTG/RPV of eight patients).Conclusion and RelevanceThe simplification of antiretroviral treatment to bitherapy with DTG/3TC or DTG/RPV has proven to be a good treatment option in terms of efficiency: patients maintain undetectable viral load after simplification of therapy and this change translates into considerable savings. However, long-term clinical results need to be verified.References and/or AcknowledgementsConflict of InterestNo conflict of interest.