Abstract
Rilpivirine (RPV) is a second-generation non-nucleoside reverse-transcriptase inhibitor used in combination antiretroviral therapy (cART)-naïve and -experienced HIV-positive adult subjects. To evaluate its efficacy and safety in these patient settings, we performed a meta-analysis of randomized controlled trials with available data at 48 and 96 weeks of follow-up.
Highlights
Rilpivirine (RPV; TMC278; Edurant®) is a secondgeneration non-nucleoside reverse-transcriptase inhibitor (NNRTI) with activity against many viral strains resistant to previous NNRTIs and a moderatehigh genetic barrier to resistance development [1,2]
[26] HIV/AIDS guidelines recommend the use of RPV as a first-line third agent coupled with a nucleoside reverse transcriptase inhibitor backbone in people living with HIV (PLWH) with CD4 count > 200 cells/μL and HIV RNA < 100,000 copies/mL starting combination antiretroviral therapy and in optimization strategies represented by RPV-based single tablet regimens
At the end of the study selection process, after excluding the last 4 articles exclusively used for extracting data on RPV safety for the qualitative synthesis of lipid changes, 14 original articles reporting on 12 distinct Randomized clinical trial (RCT) were eventually included and presented in the meta-analysis
Summary
Rilpivirine (RPV; TMC278; Edurant®) is a secondgeneration non-nucleoside reverse-transcriptase inhibitor (NNRTI) with activity against many viral strains resistant to previous NNRTIs and a moderatehigh genetic barrier to resistance development [1,2]. Current Italian [22], European [23], British [24,25] and DHHS (Department of Health and Human Services) [26] HIV/AIDS guidelines recommend the use of RPV as a first-line third agent coupled with a nucleoside reverse transcriptase inhibitor backbone in people living with HIV (PLWH) with CD4 count > 200 cells/μL and HIV RNA < 100,000 copies/mL starting combination antiretroviral therapy (cART) and in optimization strategies represented by RPV-based single tablet regimens Long-acting injectable formulations allowing oncemonthly or more distanced dosing with RPV sustainedrelease are under investigation (NCT03299049, NCT02938520, NCT03639311, and NCT02951052) or have already shown promising results, [28,29] being ready to be widely prescribed in clinical practice
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