Positioning of darunavir/cobicistat-containing antiretroviral regimens in real life: results from a large multicentre observational prospective cohort (SCOLTA).

Giordano Madeddu, Lucia Taramasso, Elena Ricci, Antonio Cascio, Laura Valsecchi, Barbara Menzaghi, Nicola Squillace, Paolo Maggi, Giuseppe Vittorio De Socio, Chiara Dentone, Giovanni F Pellicanò, Leonardo Calza, Goffredo Angioni, Paolo Bonfanti, Antonio Di Biagio

Journal: AIDS research and therapy 2020;16(1):21

PMID: 31451115

Abstract

BACKGROUND

Study aim was to evaluate the safety and durability of darunavir/cobicistat (DRV/c) in a real life setting.

METHODS

Multicentre prospective cohort study performed in the context of SCOLTA (Surveillance Cohort Long-Term Toxicity Antiretrovirals). Patients were evaluated at baseline, week 24 and 48. Changes were evaluated using the paired t test or signed rank test. The multivariable analysis was performed using a general linear model, after ranking of not normally distributed variables.

RESULTS

A total of 249 patients were included, 72 (29%) were in DRV/c-based dual therapies (DT). Hypercholesterolemia, HC, (total cholesterol (TC) ≥ 200 mg/dL or low density-C (LDL-C) ≥ 130 or statin use) was present in 121 (48.6%) and hypertriglyceridemia, (triglycerides (TG) ≥ 200 mg/dl or fibrate use) in 41 (16.5%) patients. Blood lipid profile did not change significantly in either the global population or patients with HC. After a median observation of 17 months (IQR 13-20), 59 (25.3%) patients discontinued DRV/c, of which 13 were in DT. The durability DT resulted higher than that of triple therapy (log-rank test p = 0.01). Main reasons for stopping DRV/c were simplification (15 patients), adverse events (13 patients), planned discontinuation for treatment initiation with DAA (4 patients), treatment failure (2 patients); death (2 patients), other causes (10 patients). Twenty-six were lost to follow-up.

CONCLUSIONS

DRV/c was safe and well tolerated. Dual therapies showed a better profile of tolerability and a longer durability compared to triple therapies.

Address: Department of Health Science (DISSAL), Infectious Disease Clinic, University of Genova, Genoa, Italy. [email protected].; Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy. [email protected].; Dipartimento Donna-Bambino-Neonato, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy.; Infectious Disease Unit (I Divisione), ASST Fatebenefratelli Sacco, Milan, Italy.; Infectious Disease Unit, ASST della Valle Olona, Busto Arsizio, Italy.; Infectious Disease Unit, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.; Infectious Diseases Clinic University of Campania "Luigi Vanvitelli", Neaples, Italy.; Infectious Disease Unit, Santa Maria Hospital, Perugia, Italy.; Infectious Disease Unit, Sanremo Hospital, Sanremo, Italy.; Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.; Unit of Infectious Diseases, Department of Human Pathology of the Adult and the Developmental Age "G. Barresi", University of Messina, Messina, Italy.; Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.; Infectious Disease Unit, SS Trinità Hospital, Cagliari, Italy.; Infectious Disease Unit, Ospedale A. Manzoni, Lecco, Italy.; Infectious Diseases Clinic, Policlinico Hospital San Martino, Genoa, Italy.
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