Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Pharmacology & Pharmacy, cobicistat, elvitegravir, HIV, integrase inhibitors, Quad (R), single-tablet regimens, TENOFOVIR DISOPROXIL FUMARATE, RITONAVIR-BOOSTED ELVITEGRAVIR, CO-FORMULATED ELVITEGRAVIR, SINGLE-TABLET REGIMEN, INTEGRASE INHIBITOR, DOUBLE-BLIND, TREATMENT-NAIVE, INITIAL TREATMENT, ABACAVIR-LAMIVUDINE, CROSS-RESISTANCE, Adenine, Anti-HIV Agents, Carbamates, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Cobicistat, Deoxycytidine, Drug Combinations, Drug Resistance, Multiple, Viral, Emtricitabine, HIV Infections, Humans, Organophosphonates, Quinolones, Tenofovir, Thiazoles, 1115 Pharmacology and Pharmaceutical Sciences, 3214 Pharmacology and pharmaceutical sciences

Abstract:

Introduction: The co-formulation of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) is a new, investigational, once-daily (q.d.) drug, currently undergoing Phase II and III clinical trials. Next to the nucleotide/nucleoside reverse transcriptase inhibitors FTC and TDF, it contains EVG, the second member of the HIV-1 integrase strand transfer inhibitor class, together with its pharmacokinetic booster COBI. Areas covered: In this article, the authors review EVG/COBI/FTC/TDF, in addition to discussing the single-tablet regimens (STRs) containing EFV/FTC/TDF or RPV/FTC/TDF, and the investigational combination pill containing dolutegravir, lamivudine and abacavir (DTG/3TC/ABC, 572-Trii pill). A Medline review was conducted of Phase II and III trials, as well as a review of abstracts from major HIV and infectious disease conferences from 2010 to 2012, involving EVG/COBI/FTC/TDF. Expert opinion: Next to the combination of EFV/FTC/TDF or RPV/FTC/TDF, the co-formulation of EVG/COBI/FTC/TDF offers a new, q.d., single-tablet alternative in treatment-naïve HIV patients. EVG/COBI/FTC/TDF combines a high efficacy with a good tolerability profile. The effect on the renal function and virologic failure with the development of resistance to two or more compounds present in EVG/COBI/FTC/TDF, requires further monitoring. STRs certainly bring the standard for HIV treatment and drug development to a higher level.