Fewer Drugs For the Same Level of Viral Suppression?

For those living with HIV, it’s become routine to have a three or four-drug antiretroviral regimen: integrate inhibitor, non-nucleoside reverse transcriptase inhibitor, or boosted protease inhibitor. But as Plus previously reported, studies are showing that simplifying it to a two-drug combination may be just as effective when treating people with suppressed viral loads. 

The latest study to support this comes from Viiv Healthcare (the HIV-focused company owned by GlaxoSmithKline with Pfizer Inc. and Shionogi Limited as shareholders), which just announced that both of its Phase III studies — to evaluate the safety and efficacy of switching HIV-positive participants from three or four drugs to two — have had prositive results. w

Researchers switched HIV-positive participants who had suppressed viral loads to a two-drug regiment of dolutegravir and rilpivirine, and after 48 weeks all participants showed continuous viral suppression. 

Keep in mind, however, that the use of dolutegravir and rilpivirine as HIV maintenance treatment was merely for testing. It has not approved to be used in this way anywhere in the world. There also remain questions about the impact of using two drugs instead of three or for might have on the development of drug resistance. 

“These are important results for the HIV scientific community, and represent an important milestone in our understanding of how HIV can be treated," ViiV Healthcare CEO Dominique Limet said in a statement. "The results support our strategy of investigating two-drug regimens as innovative treatment options for people living with HIV and we are planning regulatory submissions for this two-drug regimen as a single tablet in 2017.”

The study was made possible because of a collaboration between ViiV Healthcare and Janssen Sciences Ireland UC, one of the Janssen Pharmaceutical Companies of Johnson & Johnson. Their partnership was created to investigate the potential of combining dolutegravir and rilpivirine in a single tablet.