Efficacy and Safety of a Once-Daily Fixed-Dose Combination of Abacavir/Lamivudine Compared With Abacavir Twice Daily and Lamivudine Once Daily as Separate Entities in Antiretroviral-Experienced HIV-1-Infected Patients (CAL30001 Study)

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Abstract

Background:

A one-tablet, once-daily abacavir/lamivudine fixed-dose combination (FDC) has been recently approved to treat HIV-1 infection.

Methods:

A randomized, open-label, parallel-group, multicenter study to compare the efficacy and safety of the FDC group to the separate entities (SE) group, in combination with tenofovir and a new protease inhibitor or nonnucleoside reverse transcription inhibitor in antiretroviral-experienced adults experiencing virologic failure (VF). Eligible subjects had viral loads >1000 copies/mL with ≤3 nucleoside reverse transcription inhibitor-associated mutations. The primary efficacy end point was time-average changed from baseline (average area under the curve minus baseline) in plasma HIV-1 RNA over 48 weeks.

Results:

A total of 186 subjects were enrolled. The average area under the curve minus baseline was −1.65 and −1.83 log10 copies/mL in the FDC and SE groups, respectively (intention to treat; 95% confidence interval: −0.13, 0.38). Patients in the FDC (50%) and SE groups (47%) achieved viral loads <50 copies/mL based on the time to loss of virologic response algorithm. VF was low and similar in both groups (FDC, 16%; SE, 18%). Tolerability was similar between the 2 groups.

Conclusions:

The FDC group had noninferior efficacy over 48 weeks to the SE group in treatment-experienced subjects with VF.

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