Boosted vs. Unboosted Reyataz Follow Up
Nov 1, 2010
In response to a question in September, 2009, you indicated that it was likely safe to switch from Reyataz, Epzicom and Norvir to unboosted Reyataz and Epzicom. Is there any new data on this topic? What are you currently recommending to your patients who have been on boosted Reyataz and Epzicom? Thanks!
Response from Dr. Young
Hello and thanks for your question.
To be clear and transparent, I'm an investigator in this field; these studies are sponsored by the pharmaceutical company that makes Epzicom.
So, yes indeed, there is emerging data on the question of treatment of genetically screened individuals with abacavir/3TC (Epzicom, Kivexa) and atazanavir (Reyataz) with initiation ("induction") with ritonavir (Norvir) followed by simplification (or "maintenance"). This strategic approach has been studied in a clinical trial called ARIES. The 120 week study results presented at the 2010 ICAAC meeting are quite affirmative and suggest that the approach may have value to patients.
A separate study called ASSURE is assessing whether patients who are currently on a stable boosted-Reyataz regimen can safely switch to the Epzicom+Reyataz regimen.
At this point, I'm not proactively switching all of my patients on boosted-Reyataz, but certainly looking closely at these patients for intolerance, side effects or simple financial reasons to consider a change. Overall, I think that the quality of the data and lack of significant safety concerns in the ARIES trial gives us reason to take a careful look.
I hope this is helpful, BY
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