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Critical appraisal of elvitegravir in the treatment of HIV-1/AIDS

Authors Pandey K

Received 2 February 2014

Accepted for publication 10 April 2014

Published 16 May 2014 Volume 2014:6 Pages 81—90

DOI https://doi.org/10.2147/HIV.S39178

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Krishan K Pandey

Institute for Molecular Virology, Saint Louis University Health Sciences Center, St Louis, MO, USA

Abstract: Human immunodeficiency virus type 1 (HIV-1) integrase inhibitors belong to a novel class of antiretroviral drugs with high potency and better tolerability. Elvitegravir (EVG) is the second integrase inhibitor approved by the US Food and Drug Administration when administered in combination with a novel pharmacoenhancer, cobicistat (COBI), and two nucleoside/nucleotide reverse transcriptase inhibitors, emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF). This combination of drugs (EVG/COBI/FTC/TDF) developed and marketed by Gilead Sciences Inc. (Foster City, CA, USA) as STRIBILD®, is the first integrase inhibitor-based single-tablet regimen administered once-daily. In the USA, it has been approved for use in antiretroviral treatment-naïve HIV-1 patients with estimated creatinine clearance of >70 mL/min. The Department of Health and Human Services has approved EVG/COBI/FTC/TDF as one of preferred first-line regimens for HIV-1 treatment. In Europe, the European Medicines Agency has approved STRIBILD in treatment-naïve patients as well as in patients having no resistant mutation to any of the antiviral agents contained in STRIBILD. Its availability as a fixed-dose combination and once-daily dosage makes the adherence highly likely. However, it also discounts the possibility of dosage adjustment if needed.

Keywords: STRIBILD, INSTI, integrase, EVG/COBI/FTC/TDF

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