IAC 2020 Virtual July 6-10
Yogesh Punekar, ViiV Healthcare
BACKGROUND: RCT evidence has shown dolutegravir(DTG)+lamivudine(3TC) is an efficacious and durable regimen with a good safety profile in treatment-naïve and treatment-experienced HIV-infected individuals. Several observational studies have concluded that it is effective in clinical practice. The objective of this meta-analysis was to estimate effectiveness and safety of DTG+3TC in treatment-experienced, virologically suppressed people living with HIV (PLHIV) by combining real-world evidence (RWE) from clinical practice.
METHODS: A systematic literature review of PubMed and Embase along with 24 regional and international conferences was conducted between 2013-Dec 2019 to identify non-RCT studies of DTG+3TC in PLHIV. Eligible published articles presenting outcomes of interest were identified and extracted. Identified studies were included if they had acceptable level of publications bias and heterogeneity determined using funnel plots and I2statistics, respectively. One-arm meta-analyses using the Dersimonian and Laird method were conducted to estimate effect sizes for viral failure, viral suppression, and discontinuations for DTG+3TC.
RESULTS: A total of 7 DTG+3TC studies (n=1,800 patients) reported data on treatment experienced virologically suppressed PLHIV on outcomes of interest at different timepoints. Results showed that among patients switching to DTG+3TC treatment '90% maintained virological suppression (ITT) with '1% viral failures. Table 1: Proportion of patients with viral failure, virological suppression and discontinuations at week 48.