Efficacy and safety outcomes among treatment-experienced women and men treated with etravirine in gender, race and clinical experience.
The GRACE (Gender, Race and Clinical Experience) trial enrolled treatment-experienced, HIV-1-infected patients, mainly women, in North America, to assess outcomes with a darunavir/ritonavir-based regimen, which could include etravirine (ETR). We present outcomes at week 48 for men and women receiving ETR. Virologic response (HIV-1 RNA <50 copies/ml) and safety were assessed; descriptive statistics are reported. To evaluate the independent contribution of ETR treatment, a post hoc analysis including a multivariate model assessed factors predictive of virologic response for the entire GRACE population (429 patients). Of 207 patients who received ETR (women, 57.5%; black or Hispanic, 81.7%), 71.4% of women and 79.5% of men completed the study. Week 48 virologic response rates in women and men (intent-to-treat population) were 58.0% and 61.4%, respectively. After censoring patients who discontinued treatment for reasons other than virologic failure, response rates were 79.3% and 73.0%, respectively. Overall, ETR was well tolerated. Women experienced more nausea (24.4% vs. 11.4%) and rash-related events (21.0% vs. 15.9%), but less diarrhea (15.1% vs. 21.6%), compared with men. Grade 3-4 hypertriglyceridemia was more common in men (9.3%) than women (1.1%). In total, 11 (9.2%) women and 7 (8.0%) men discontinued ETR due to adverse events. In the multivariate model of the entire GRACE population, ETR use was independently associated with improved virologic response. ETR is effective and well tolerated in treatment-experienced patients with HIV-1, with similar outcomes among women and men.
Department of Medicine, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA. hoddersa@umdnj.edu
Sally
S
Hodder
Dushyantha
D
Jayaweera
Joseph
J
Mrus
Robert
R
Ryan
James
J
Witek
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000069454:Darunavir; D024921:Drug Resistance, Multiple, Viral / Q000276:immunology; D005260:Female; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D009570:Nitriles; D009656:North America / Q000453:epidemiology; D011724:Pyridazines / Q000627:therapeutic use*; D011743:Pyrimidines; D012367:RNA, Viral / Q000187:drug effects; D019438:Ritonavir / Q000627:therapeutic use*; D017678:Sex Distribution; D012737:Sex Factors; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D012367:RNA, Viral; D013449:Sulfonamides; C451734:etravirine; D019438:Ritonavir; D000069454:Darunavir