Once daily maraviroc 300 mg or 150 mg in combination with ritonavir-boosted darunavir 800/100 mg

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Abstract

Objectives

To describe the pharmacokinetics of maraviroc when dosed at 150 or 300 mg once daily with 800/100 mg of darunavir/ritonavir.

Methods

A retrospective case-note review of HIV-infected adults taking maraviroc was conducted. Patients on a maraviroc-based regimen for a minimum of 5 weeks were grouped as receiving: (i) 300 mg of maraviroc twice daily with 245 mg of tenofovir/200 mg of emtricitabine; (ii) 300 mg of maraviroc once daily with 800/100 mg of darunavir/ritonavir once daily; and (iii) 150 mg of maraviroc once daily with 800/100 mg of darunavir/ritonavir once daily. Ctrough and Cpeak data were collected at 2, 12 or 24 h post-dose.

Results

Sixty-six patients were included, providing 115 samples. The median (IQR) Cpeak was 378 (350–640) ng/mL for 300 mg of maraviroc twice daily with 245 mg of tenofovir/200 mg of emtricitabine (n = 9), 728 (378–935) ng/mL for 300 mg of maraviroc once daily with darunavir/ritonavir (n = 29) and 364 (104–624) ng/mL for 150 mg of maraviroc once daily with darunavir/ritonavir (n = 2; P = 0.24). The median (IQR) Ctrough was 46 (33–61) ng/mL for 300 mg of maraviroc twice daily with 245 mg of tenofovir/200 mg of emtricitabine (n = 12), 70 (49–97) ng/mL for 300 mg of maraviroc once daily with darunavir/ritonavir (n = 34) and 43 (35–55) ng/mL for 150 mg of maraviroc once daily with darunavir/ritonavir (n = 17; P = 0.001). The maraviroc Ctrough in black patients (n = 34) was 61 (45–110) ng/mL and in white patients (n = 29) it was 49 (42–70) ng/mL (P = 0.04). The Cpeak in black patients (n = 20) was 800 (397–1060) ng/mL versus 387 (336–723) ng/mL in white patients (n = 20; P = 0.02).

Conclusions

Once daily coadministration of 300 mg of maraviroc with 800/100 mg of darunavir/ritonavir was well tolerated and had favourable pharmacokinetics when compared with 300 mg of maraviroc twice daily with 245 mg of tenofovir/200 mg of emtricitabine. A 24% higher Ctrough and 107% higher Cpeak was seen in black patients compared with white patients.

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