title: Rilpivirine.
abstract: Rilpivirine is an orally administered, non-nucleoside reverse transcriptase inhibitor that is a component drug in combination therapy for antiretroviral-naive patients with HIV-1 infection. The randomized, double-blind, double-dummy, multinational ECHO and THRIVE trials in antiretroviral-naive adult patients with HIV-1 infection compared rilpivirine with efavirenz, administered with background nucleoside/nucleotide antiretroviral regimens. Rilpivirine 25 mg once daily recipients had a treatment response (confirmed plasma HIV-1 RNA level of <50 copies/mL at 48 weeks; primary endpoint) that was noninferior to that of efavirenz 600 mg once daily recipients. The response rates in the rilpivirine and efavirenz groups were 83% and 84% (ECHO) and 87% and 83% (THRIVE). Virological failure rates in rilpivirine and efavirenz groups in the intent-to-treat analysis were 11% and 4% in the ECHO trial and 7% and 5% in the THRIVE trial. In a pooled analysis of both trials, in rilpivirine recipients with an HIV-1 RNA level of >100,000 copies/mL at baseline, the virological failure rate at 48 weeks was 15% (vs 6% with efavirenz), whereas in those with a level of ≤100,000 copies/mL, the virological failure rate was 4% (vs 3% with efavirenz). In general, rilpivirine was better tolerated than efavirenz throughout treatment. Rilpivirine recipients had significantly fewer treatment-related adverse events, discontinuations because of adverse events, psychiatric-neurological adverse events and a significantly lower rate of blood lipid abnormalities.
authors.affiliation: Adis, Auckland, New Zealand. demail@adis.co.nz
authors.forename: Mark
authors.initials: M
authors.lastname: Sanford
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D009570:Nitriles / Q000494:pharmacology*; D011743:Pyrimidines / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D000068696:Rilpivirine; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D009570:Nitriles; D011743:Pyrimidines; D054303:HIV Reverse Transcriptase; D000068696:Rilpivirine