This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.
EACS: Katlama and Genvoya®
predictable cul-de-sac:
Bad choice. Stribild ® or Genvoya ® could jeopardize the transition to Tivicay® monotherapy, a gateway to HypoDolu. ICCARRE and ... 1/7 ... well, with this virologist, you are not there yet. Consider virologist change ...
Buzz: Genvoya® could jeopardize Tivicay® monotherapy
Is Dolutegravir (found in Tivicay ® or Triumeq ®) your absolutely perfect molecule, that overcomes all resistance and prognostics? For naïve patients (who have never taken any treatment or those who have taken treatment but not Isentress® nor Stribild® / Genvoya®) this is the case! It's stunning! The SAILING test (previously treated patients with multiple failures) shows a very good success rate but also some failures in patients with mutations on integrase. This looks good almost everywhere, but not everywhere. There is a border somewhere ... Where is it? What about patients who have never failed INI? Does the absence of failure under Isentress® Stribild®, suffice it to anticipate the same overall success as that seen in patients who have never taken these two drugs? At the border, it is not all white or all black.
The border is this presentation Christine Katlama. We find a complete narration in the article by Catie, here. It's long and tedious; transparencies, in English, are more meaningful. Accounting is the same.
Some Patients who had used either Isentress® be Stribild® / Genvoya® failed Tivicay ® monotherapy.
The gray area, it is there: to have (or not) previously used these first generation INIs . Light gray, dark gray, medium gray? This remains to be determined. But one thing is certain: the 3 patients (in Paris, on 13 having already taken Isentress® or Stribild®) and 1 Barcelona will not disappear from the balance sheet.
The gray area is located there, and, this is quite a disappointment for the patients at risk, and a great victory for patients who are not: patients who have never taken neither Isentress® nor Stribild®/Genvoya®, are free of risk they may consider, without reservation, switching to Tivicay ® monotherapy in 7/7, and understand that monotherapy is an effective firstline therapy, and therefore we can later consider the ICCARRE reductions: 6/7, 4 / 7 and 1/7 (= HYPODOLU).
Recommended by a reader: the latest issue of Catie addresses both Genvoya® and Tivicay® monotherapy.
In France, our HAS [High Authority on Health] has issued a very reserved opinion on Stribild®, so we wonder what the ruling will be for Genvoya® (read here and see point # 4):
[...] STRIBILD has not shown improved efficiency, has a low genetic barrier to resistance, many drug interactions [...]
We will keep here proper accounting, accurately and comprehensively of failures induced by the use of old INIS. The HAS [High Authority on Health] was right on: one should have avoided Stribild® (/ Genvoya®)!
Good reading, good weekend and good fuck
This paper was originally published here, in French. We provide this translation for your convenience. Some practical aspects may differ where you live.
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