eCase - ART Safety Data: Summer 2021

Eric S. Daar, MD:
This Clinical Focus module will center on emerging insights about adverse events (AEs) during antiretroviral therapy (ART) and implications for treatment, with a focus on data from the 11th International AIDS Society Conference on HIV Science (IAS 2021).

We will look at AEs that may be unique to given drugs and those that may be relevant across many therapeutics, such as metabolic parameters, particularly lipid abnormalities; insulin resistance; and—of importance—weight changes.

We generally obtain this information from randomized, controlled trials of patients who are treatment naive and initiating first-line ART or, increasingly, patients switching from a stable ART regimen to a new regimen. I will discuss studies of both first-line and treatment-switching scenarios to better understand how specific drugs and/or changes in regimens may impact some of these potential AEs.

The slide thumbnails in this activity link to a complete PowerPoint slideset that can be found here or downloaded by clicking any of the thumbnails within the activity.

Clinical Care Options plans to measure the educational impact of this activity, and some questions will be asked twice: once before the discussion that informs the best choice and again after that specific discussion. Your responses will be aggregated for analysis, but your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

The Week 144 analysis from the TANGO noninferiority study of switching to dolutegravir (DTG)/lamivudine (3TC) vs continuing ≥3-drug tenofovir alafenamide (TAF)–based ART showed which of the following metabolic outcomes compared with baseline?

A. Changes in glucose and insulin resistance favored DTG/3TC
B. Changes in fasting lipids favored DTG/3TC
C. Percentage of participants with metabolic syndrome was greater in the DTG/3TC arm
D. Weight gain was significantly greater in TAF-based ART
E. I’m uncertain

In an observational study of weight and insulin resistance among PWH, what was the rate of insulin resistance in those who switched to an INSTI-containing regimen vs remaining INSTI naive?

A. Significantly higher with INSTI vs no INSTI in the overall population
B. Significantly lower with INSTI vs no INSTI in the overall population
C. Significantly higher with INSTI vs no INSTI, but only in the subset without insulin resistance at switch
D. Significantly lower with INSTI vs no INSTI, but only in the subset without insulin resistance at switch
E. I’m uncertain

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Adverse Events During ART and Implications for Treatment: Key Data From Summer 2021

Eric S. Daar, MD

Activity

The Week 144 analysis from the TANGO noninferiority study of switching to dolutegravir (DTG)/lamivudine (3TC) vs continuing ≥3-drug tenofovir alafenamide (TAF)–based ART showed which of the following metabolic outcomes compared with baseline?

In an observational study of weight and insulin resistance among PWH, what was the rate of insulin resistance in those who switched to an INSTI-containing regimen vs remaining INSTI naive?