Population pharmacokinetics and pharmacogenetics of ritonavir-boosted darunavir in the presence of raltegravir or tenofovir disoproxil fumarate/emtricitabine in HIV-infected adults and the relationship with virological response : a sub-study of the NEAT001/ANRS143 randomized trial

Dickinson, L.; Gurjar, R.; Stohr, W.; Bonora, S.; Owen, A.; D'Avolio, A.; Cursley, A.; Molina, J.-.; Faetkenheuer, G.; Vandekerckhove, L.; Di Perri, G.; Pozniak, A.; Richert, L.; Raffi, F.; Boffito, M.; Dedes, N.; Chene, G.; Allavena, C.; Autran, B.; Antinori, A.; Bucciardini, R.; Vella, S.; Horban, A.; Arribas, J.; Babiker, A.G.; Pillay, D.; Franquet, X.; Schwarze, S.; Grarup, J.; Fischer, A.; Wallet, C.; Diallo, A.; Saillard, J.; Moecklinghoff, C.; Stellbrink, H.-.; Vanleeuwen, R.; Gatell, J.; Sandstrom, E.; Flepp, M.; Ewings, F.; George, E.C.; Hudson, F.; Pearce, G.; Quercia, R.; Rogatto, F.; Leavitt, R.; Nguyen, B.-.; Peto, T.; Goebel, F.; Marcotullio, S.; Miller, V.; Sasieni, P.; Arnault, F.; Boucherie, C.; Jean, D.; Paniego, V.; Paraina, F.; Rouch, E.; Schwimmer, C.; Soussi, M.; Taieb, A.; Termote, M.; Touzeau, G.; Babiker, A.; Dodds, W.; Hoppe, A.; Kummeling, I.; Pacciarini, F.; Paton, N.; Russell, C.; Taylor, K.; Ward, D.; Aagaard, B.; Eid, M.; Gey, D.; Gramjensen, B.; Jakobsen, M.-.; Jansson, P.O.; Jensen, K.; Mariajoensen, Z.; Moseholmlarsen, E.; Pahl, C.; Pearson, M.; Nielsen, B.R.; Reilev, S.S.; Christ, I.; Lathouwers, D.; Manting, C.; Van Leeuwen, R.; Mendy, B.; Metro, A.; Couffin-Cadiergues, S.; Knellwolf, A.-.; Palmisiano, L.; Aznar, E.; Barea, C.; Cotarelo, M.; Esteban, H.; Girbau, I.; Moyano, B.; Ramirez, M.; Saiz, C.; Sanchez, I.; Yllescas, M.; Binelli, A.; Colasanti, V.; Massella, M.; Anagnostou, O.; Gioukari, V.; Touloumi, G.; Schmied, B.; Rieger, A.; Vetter, N.; Dewit, S.; Florence, E.; Gerstoft, J.; Mathiesen, L.; Katlama, C.; Cabie, A.; Cheret, A.; Dupon, M.; Ghosn, J.; Girard, P.-.; Goujard, C.; Levy, Y.; Morlat, P.; Neau, D.; Obadia, M.; Perre, P.; Piroth, L.; Reynes, J.; Tattevin, P.; Ragnaud, J.M.; Weiss, L.; Yazdan, Y.; Yeni, P.; Zucman, D.; Esser, S.; Fatkenheuer, G.; Hoffmann, C.; Jessen, H.; Rockstroh, J.; Schmidt, R.; Stephan, C.; Unger, S.; Hatzakis, A.; Daikos, G.L.; Papadopoulos, A.; Skoutelis, A.; Banhegyi, D.; Mallon, P.; Mulcahy, F.; Andreoni, M.; Castelli, F.; D'Arminiomonforte, A.; Diperri, G.; Galli, M.; Lazzarin, A.; Mazzotta, F.; Torti, C.; Vullo, V.; Prins, J.; Richter, C.; Verhagen, D.; Vaneeden, A.; Doroana, M.; Antunes, F.; Maltez, F.; Sarmento-Castro, R.; Gonzalez Garcia, J.; Aldeguer, J.L.; Clotet, B.; Domingo, P.; Gatell, J.M.; Knobel, H.; Marquez, M.; Pilarmiralles, M.; Portilla, J.; Soriano, V.; Tellez, M.; Thalme, A.; Blaxhult, A.; Gisslen, M.; Winston, A.; Fox, J.; Gompels, M.; Herieka, E.; Johnson, M.; Leen, C.; Teague, A.; Williams, I.; Boyd, M.; Moller, N.F.; Moseholmlarsen, E.F.; Lemoing, V.; Wit, F.W.N.M.; Kowalska, J.; Berenguer, J.; Moreno, S.; Muller, N.J.; Torok, E.; Post, F.; Angus, B.; Calvez, V.; Boucher, C.; Collins, S.; Dunn, D.; Lambert, S.; Marcelin, A.-.; Perno, C.F.; White, E.; Ammassari, A.; Schmidt, R.E.; Odermarsky, M.; Smith, C.; Thiebaut, R.; Delaserna, J.I.B.; Castagna, A.; De Wit, S.; Furrer, H.-.; Mocroft, A.; Reiss, P.; Fragola, V.; Lauriola, M.; Murri, R.; Nieuwkerk, P.; Spire, B.; Volny-Anne, A.; West, B.; Amieva, H.; Llibre Codina, J.; Braggion, M.; Foca, E.

doi:10.1093/jac/dkz479

Objectives: NEAT001/ANRS143 demonstrated non-inferiority of once-daily darunavir/ritonavir (800/100 mg) + twice-daily raltegravir (400 mg) versus darunavir/ritonavir + tenofovir disoproxil fumarate/emtricitabine (245/200 mg once daily) in treatment-naive patients. We investigated the population pharmacokinetics of darunavir, ritonavir, tenofovir and emtricitabine and relationships with demographics, genetic polymorphisms and virological failure. Methods: Non-linear mixed-effects models (NONMEM v. 7.3) were applied to determine pharmacokinetic parameters and assess demographic covariates and relationships with SNPs (SLCO3A1, SLCO1B1, NR1I2, NR1I3, CYP3A5∗3, CYP3A4∗22, ABCC2, ABCC10, ABCG2 and SCL47A1). The relationship between model-predicted darunavir AUC0-24 and C24 with time to virological failure was evaluated by Cox regression. Results: Of 805 enrolled, 716, 720, 347 and 361 were included in the darunavir, ritonavir, tenofovir and emtricitabine models, respectively (11% female, 83% Caucasian). No significant effect of patient demographics or SNPs was observed for darunavir or tenofovir apparent oral clearance (CL/F); coadministration of raltegravir did not influence darunavir or ritonavir CL/F. Ritonavir CL/F decreased by 23% in NR1I2 63396C>T carriers and emtricitabine CL/F was linearly associated with creatinine clearance (P<0.001). No significant relationship was demonstrated between darunavir AUC0-24 or C24 and time to virological failure [HR (95% CI): 2.28 (0.53-9.80), P=0.269; and 1.82 (0.61-5.41), P=0.279, respectively]. Conclusions: Darunavir concentrations were unaltered in the presence of raltegravir and not associated with virological failure. Polymorphisms investigated had little impact on study-drug pharmacokinetics. Darunavir/ritonavir + raltegravir may be an appropriate option for patients experiencing NRTI-associated toxicity.

Population pharmacokinetics and pharmacogenetics of ritonavir-boosted darunavir in the presence of raltegravir or tenofovir disoproxil fumarate/emtricitabine in HIV-infected adults and the relationship with virological response : a sub-study of the NEAT001/ANRS143 randomized trial / L. Dickinson, R. Gurjar, W. Stohr, S. Bonora, A. Owen, A. D'Avolio, A. Cursley, J.-. Molina, G. Faetkenheuer, L. Vandekerckhove, G. Di Perri, A. Pozniak, L. Richert, F. Raffi, M. Boffito, N. Dedes, G. Chene, C. Allavena, B. Autran, A. Antinori, R. Bucciardini, S. Vella, A. Horban, J. Arribas, A.G. Babiker, D. Pillay, X. Franquet, S. Schwarze, J. Grarup, A. Fischer, C. Wallet, A. Diallo, J. Saillard, C. Moecklinghoff, H.-. Stellbrink, R. Vanleeuwen, J. Gatell, E. Sandstrom, M. Flepp, F. Ewings, E.C. George, F. Hudson, G. Pearce, R. Quercia, F. Rogatto, R. Leavitt, B.-. Nguyen, T. Peto, F. Goebel, S. Marcotullio, V. Miller, P. Sasieni, F. Arnault, C. Boucherie, D. Jean, V. Paniego, F. Paraina, E. Rouch, C. Schwimmer, M. Soussi, A. Taieb, M. Termote, G. Touzeau, A. Babiker, W. Dodds, A. Hoppe, I. Kummeling, F. Pacciarini, N. Paton, C. Russell, K. Taylor, D. Ward, B. Aagaard, M. Eid, D. Gey, B. Gramjensen, M.-. Jakobsen, P.O. Jansson, K. Jensen, Z. Mariajoensen, E. Moseholmlarsen, C. Pahl, M. Pearson, B.R. Nielsen, S.S. Reilev, I. Christ, D. Lathouwers, C. Manting, R. Van Leeuwen, B. Mendy, A. Metro, S. Couffin-Cadiergues, A.-. Knellwolf, L. Palmisiano, E. Aznar, C. Barea, M. Cotarelo, H. Esteban, I. Girbau, B. Moyano, M. Ramirez, C. Saiz, I. Sanchez, M. Yllescas, A. Binelli, V. Colasanti, M. Massella, O. Anagnostou, V. Gioukari, G. Touloumi, B. Schmied, A. Rieger, N. Vetter, S. Dewit, E. Florence, J. Gerstoft, L. Mathiesen, C. Katlama, A. Cabie, A. Cheret, M. Dupon, J. Ghosn, P.-. Girard, C. Goujard, Y. Levy, P. Morlat, D. Neau, M. Obadia, P. Perre, L. Piroth, J. Reynes, P. Tattevin, J.M. Ragnaud, L. Weiss, Y. Yazdan, P. Yeni, D. Zucman, S. Esser, G. Fatkenheuer, C. Hoffmann, H. Jessen, J. Rockstroh, R. Schmidt, C. Stephan, S. Unger, A. Hatzakis, G.L. Daikos, A. Papadopoulos, A. Skoutelis, D. Banhegyi, P. Mallon, F. Mulcahy, M. Andreoni, F. Castelli, A. D'Arminiomonforte, G. Diperri, M. Galli, A. Lazzarin, F. Mazzotta, C. Torti, V. Vullo, J. Prins, C. Richter, D. Verhagen, A. Vaneeden, M. Doroana, F. Antunes, F. Maltez, R. Sarmento-Castro, J. Gonzalez Garcia, J.L. Aldeguer, B. Clotet, P. Domingo, J.M. Gatell, H. Knobel, M. Marquez, M. Pilarmiralles, J. Portilla, V. Soriano, M. Tellez, A. Thalme, A. Blaxhult, M. Gisslen, A. Winston, J. Fox, M. Gompels, E. Herieka, M. Johnson, C. Leen, A. Teague, I. Williams, M. Boyd, N.F. Moller, E.F. Moseholmlarsen, V. Lemoing, F.W.N.M. Wit, J. Kowalska, J. Berenguer, S. Moreno, N.J. Muller, E. Torok, F. Post, B. Angus, V. Calvez, C. Boucher, S. Collins, D. Dunn, S. Lambert, A.-. Marcelin, C.F. Perno, E. White, A. Ammassari, R.E. Schmidt, M. Odermarsky, C. Smith, R. Thiebaut, J.I.B. Delaserna, A. Castagna, S. De Wit, H.-. Furrer, A. Mocroft, P. Reiss, V. Fragola, M. Lauriola, R. Murri, P. Nieuwkerk, B. Spire, A. Volny-Anne, B. West, H. Amieva, J. Llibre Codina, M. Braggion, E. Foca. - In: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. - ISSN 0305-7453. - 75:3(2020 Mar), pp. 628-639. [10.1093/jac/dkz479]

Population pharmacokinetics and pharmacogenetics of ritonavir-boosted darunavir in the presence of raltegravir or tenofovir disoproxil fumarate/emtricitabine in HIV-infected adults and the relationship with virological response : a sub-study of the NEAT001/ANRS143 randomized trial

Dickinson L.;Gurjar R.;Stohr W.;Bonora S.;Owen A.;D'Avolio A.;Cursley A.;Molina J. -M.;Faetkenheuer G.;Vandekerckhove L.;Di Perri G.;Pozniak A.;Richert L.;Raffi F.;Boffito M.;Dedes N.;Chene G.;Allavena C.;Autran B.;Antinori A.;Bucciardini R.;Vella S.;Horban A.;Arribas J.;Babiker A. G.;Pillay D.;Franquet X.;Schwarze S.;Grarup J.;Fischer A.;Wallet C.;Diallo A.;Saillard J.;Moecklinghoff C.;Stellbrink H. -J.;Vanleeuwen R.;Gatell J.;Sandstrom E.;Flepp M.;Ewings F.;George E. C.;Hudson F.;Pearce G.;Quercia R.;Rogatto F.;Leavitt R.;Nguyen B. -Y.;Peto T.;Goebel F.;Marcotullio S.;Miller V.;Sasieni P.;Arnault F.;Boucherie C.;Jean D.;Paniego V.;Paraina F.;Rouch E.;Schwimmer C.;Soussi M.;Taieb A.;Termote M.;Touzeau G.;Babiker A.;Dodds W.;Hoppe A.;Kummeling I.;Pacciarini F.;Paton N.;Russell C.;Taylor K.;Ward D.;Aagaard B.;Eid M.;Gey D.;Gramjensen B.;Jakobsen M. -L.;Jansson P. O.;Jensen K.;Mariajoensen Z.;Moseholmlarsen E.;Pahl C.;Pearson M.;Nielsen B. R.;Reilev So. S.;Christ I.;Lathouwers D.;Manting C.;Van Leeuwen R.;Mendy B.;Metro A.;Couffin-Cadiergues S.;Knellwolf A. -L.;Palmisiano L.;Aznar E.;Barea C.;Cotarelo M.;Esteban H.;Girbau I.;Moyano B.;Ramirez M.;Saiz C.;Sanchez I.;Yllescas M.;Binelli A.;Colasanti V.;Massella M.;Anagnostou O.;Gioukari V.;Touloumi G.;Schmied B.;Rieger A.;Vetter N.;Dewit S.;Florence E.;Gerstoft J.;Mathiesen L.;Katlama C.;Cabie A.;Cheret A.;Dupon M.;Ghosn J.;Girard P. -M.;Goujard C.;Levy Y.;Morlat P.;Neau D.;Obadia M.;Perre P.;Piroth L.;Reynes J.;Tattevin P.;Ragnaud J. M.;Weiss L.;Yazdan Y.;Yeni P.;Zucman D.;Esser S.;Fatkenheuer G.;Hoffmann C.;Jessen H.;Rockstroh J.;Schmidt R.;Stephan C.;Unger S.;Hatzakis A.;Daikos G. L.;Papadopoulos A.;Skoutelis A.;Banhegyi D.;Mallon P.;Mulcahy F.;Andreoni M.;Castelli F.;A. D'Arminiomonforte;Diperri G.;M. Galli;A. Lazzarin;Mazzotta F.;Torti C.;Vullo V.;Prins J.;Richter C.;Verhagen D.;Vaneeden A.;Doroana M.;Antunes F.;Maltez F.;Sarmento-Castro R.;Gonzalez Garcia J.;Aldeguer J. L.;Clotet B.;Domingo P.;Gatell J. M.;Knobel H.;Marquez M.;Pilarmiralles M.;Portilla J.;Soriano V.;Tellez M.;Thalme A.;Blaxhult A.;Gisslen M.;Winston A.;Fox J.;Gompels M.;Herieka E.;Johnson M.;Leen C.;Teague A.;Williams I.;Boyd M.;Moller N. F.;Moseholmlarsen E. F.;Lemoing V.;Wit F. W. N. M.;Kowalska J.;Berenguer J.;Moreno S.;Muller N. J.;Torok E.;Post F.;Angus B.;Calvez V.;Boucher C.;Collins S.;Dunn D.;Lambert S.;Marcelin A. -G.;C.F. Perno;White E.;Ammassari A.;Schmidt R. E.;Odermarsky M.;Smith C.;Thiebaut R.;Delaserna J. I. B.;Castagna A.;De Wit S.;Furrer H. -J.;Mocroft A.;Reiss P.;Fragola V.;Lauriola M.;Murri R.;Nieuwkerk P.;Spire B.;Volny-Anne A.;West B.;Amieva H.;Llibre Codina J.;Braggion M.;Foca E.

2020

Abstract

Objectives: NEAT001/ANRS143 demonstrated non-inferiority of once-daily darunavir/ritonavir (800/100 mg) + twice-daily raltegravir (400 mg) versus darunavir/ritonavir + tenofovir disoproxil fumarate/emtricitabine (245/200 mg once daily) in treatment-naive patients. We investigated the population pharmacokinetics of darunavir, ritonavir, tenofovir and emtricitabine and relationships with demographics, genetic polymorphisms and virological failure. Methods: Non-linear mixed-effects models (NONMEM v. 7.3) were applied to determine pharmacokinetic parameters and assess demographic covariates and relationships with SNPs (SLCO3A1, SLCO1B1, NR1I2, NR1I3, CYP3A5∗3, CYP3A4∗22, ABCC2, ABCC10, ABCG2 and SCL47A1). The relationship between model-predicted darunavir AUC0-24 and C24 with time to virological failure was evaluated by Cox regression. Results: Of 805 enrolled, 716, 720, 347 and 361 were included in the darunavir, ritonavir, tenofovir and emtricitabine models, respectively (11% female, 83% Caucasian). No significant effect of patient demographics or SNPs was observed for darunavir or tenofovir apparent oral clearance (CL/F); coadministration of raltegravir did not influence darunavir or ritonavir CL/F. Ritonavir CL/F decreased by 23% in NR1I2 63396C>T carriers and emtricitabine CL/F was linearly associated with creatinine clearance (P<0.001). No significant relationship was demonstrated between darunavir AUC0-24 or C24 and time to virological failure [HR (95% CI): 2.28 (0.53-9.80), P=0.269; and 1.82 (0.61-5.41), P=0.279, respectively]. Conclusions: Darunavir concentrations were unaltered in the presence of raltegravir and not associated with virological failure. Polymorphisms investigated had little impact on study-drug pharmacokinetics. Darunavir/ritonavir + raltegravir may be an appropriate option for patients experiencing NRTI-associated toxicity.

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				Settore MED/17 - Malattie Infettive
Settore MED/07 - Microbiologia e Microbiologia Clinica
			
	Data di pubblicazione
	
				mar-2020
			
	Data ahead of print o data di stampa
	
				21-nov-2019
			
	Rivista in ANCE
	
				JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
			
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				https://dx.doi.org/10.1093/jac/dkz479
			
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