Clinical use of HIV integrase inhibitors: a systematic review and meta-analysis.
Messiaen P, Wensing AM, Fun A, Nijhuis M, Brusselaers N, Vandekerckhove L.
PLoS One 2013,8:e52562
15 February 2013, by Pr Pedro Cahn
This paper reviewed literature between April 2006 and November 2012 on randomized controlled trials, nonrandomized controlled trials and cohort studies on integrase inhibitor use in clinical practice. Among the 48 identified studies, 16 with similar outcome measures and indication, comparing integrase inhibitors to placebo or another drug class were selected for a meta-analysis. Modified ITT analysis of virologic outcome was performed. In antiretroviral-naïve patients (10 studies), virologic outcome was in favour of integrase inhibitor-based regimens : odds ratio of 0.71, 95% CI : 0.59–0.86. In antiretroviral-experienced patients with virologic suppression (3 studies, all with raltegravir), the outcome of switching to integrase inhibitor was not favourable : odds ratio of 1.43 ; 95% CI : 0.89 – 2.31. Integrase inhibitor-based regimens resulted in similar immunological responses compared to other regimens. A low genetic barrier to drug-resistance development was observed for raltegravir and elvitegravir, but not for dolutegravir.
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