Switch studies in virologically suppressed patients

Switch to LPV/ r + 3TC
OLE Study
Original article : Arribas JR. Lancet Infect Dis 2015; 2015; 15:785-92
Last update : 17/07/2015

Dr Anton Pozniak
Chelsea and Westminster Hospital
London, UK

  • In virologically suppressed patients on a triple-drug antiretroviral regimen with LPV/r + 2NRTI, switching to LPV/r + 3TC or FTC demonstrated non-inferior efficacy and comparable safety to LPV/r + 2 NRTI, as maintenance therapy
  • Percentage of patients with protocol defined virological failure were very small and similar between arms
  • Dual therapy with LPV/r + 3TC or FTC has the potential benefit of preserving future options, reducing the cost of antiretroviral therapy and minimizing potential long term toxicity

Design :


* Randomisation was stratified on time to HIV suppression (< or > 1 year)
and nadir CD4 cell count (< or > 100/ m l)

Objective :

  • Primary Endpoint : proportion without treatment failure at W48 (ITT)
    • Treatment failure : 2 consecutive HIV RNA ≥ 50 c/mL , death, new AIDS event, loss to follow-up, or change or permanent discontinuation of any antiretroviral drug
    • Non-inferiority of dual therapy, upper limit of the 2-sided 95% CI for the difference = 12%, 80% power

Baseline characteristics and patient disposition :

Efficacy results at W48

Safety at W48


Small but significant increase of eGFR (MDRD), total and LDL cholesterol in the dual treatment group at 48 weeks compared with the triple treatment group

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