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Tytuł:
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Dynamics of creatinine estimated glomerular filtration rate using one or more antiretrovirals that inhibit creatinine tubular secretion.
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Autorzy:
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Perez Elias MJ; Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
Alejos B; Instituto de Salud Carlos III Madrid, Madrid, Spain.
Gutierrez MM; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Crespo M; Hospital Universitario Alvaro Cunqueiro, Vigo, Spain.
De Los Santos Gil I; Hospital Universitario de La Princesa, Madrid, Spain.
Ribera E; Vall d'Hebron Research Institute, Barcelona, Spain.
Galindo MJ; Hospital Clinic of Valencia, Valencia, Spain.
Lozano F; Hospital Universitario de Valme, Sevilla, Spain.
Payeras Cifre A; Hospital Son Llàtzer, Palma de Mallorca, Spain.
Boix V; Hospital General Universitario de Alicante, Alicante, Spain.
Montero-Alonso M; Hospital Universitario y Politecnico La Fe, Valencia, Spain.
Sanz J; Hospital Universitario de Guadalajara, Guadalajara, Spain.
De La Torre Lima J; Hospital Costa del Sol, Marbella, Spain.
Palacios R; Hospital Virgen de la Victoria, IBIMA, Málaga, Spain.
De La Fuente Moral S; Clinica Puerta de Hierro, Madrid, Spain.
Martinez E; Hospital Clinic de Barcelona, Barcelona, Spain.
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Corporate Authors:
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Codar Study Group
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Źródło:
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The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2021 Mar 12; Vol. 76 (4), pp. 1046-1050.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 1997- : London : Oxford University Press
Original Publication: London, New York, Academic Press.
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MeSH Terms:
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Anti-HIV Agents*/therapeutic use
HIV Infections*/drug therapy
Cobicistat/therapeutic use ; Creatinine ; Darunavir/therapeutic use ; Glomerular Filtration Rate ; Humans ; Retrospective Studies
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Contributed Indexing:
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Investigator: P Callau; RY Cajal; A Moreno; JL Casado; JM Sanchez; CG Ayerbe; P Vizcarra; S Del Campo; E Negredo; I Campos; J Puig; E Ribera; A Torrella; B Planas; H Knobel; R Ferrando; M Crespo; A Ocampo; J Sanz; I de Los Santos; A Moreno; A Díaz; LM Carbonero; J de la Torre; JMG De Lomas; MR Reina; J Santos; CM González Domenech; MM Gutierrez; M Montero; S Cuéllar; M Tasias; I Castro; V Boix; A Payeras; P Ryan; M Torralba; E Aznar; H Esteban; M de Miguel; P Gonzalez; M Yllescas
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Molecular Sequence:
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ClinicalTrials.gov NCT03042390
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Substance Nomenclature:
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0 (Anti-HIV Agents)
AYI8EX34EU (Creatinine)
LW2E03M5PG (Cobicistat)
YO603Y8113 (Darunavir)
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Entry Date(s):
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Date Created: 20210127 Date Completed: 20210705 Latest Revision: 20210705
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Update Code:
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20240105
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DOI:
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10.1093/jac/dkaa547
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PMID:
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33501995
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Background: Cobicistat, dolutegravir and rilpivirine are all modest inhibitors of proximal tubular creatinine secretion (IPTCrS) and hence a moderate and early non-progressive creatinine estimated glomerular filtration rate (Cr-eGFR) reduction has been observed in clinical trials. Data regarding the impact of combination of those drugs on Cr-eGFR, in the clinical practice, are scarcely known.
Methods: Changes in Cr-eGFR after starting darunavir/cobicistat alone or in combination with dolutegravir and/or rilpivirine were studied in a nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat. The relationship between Cr-eGFR changes over time and the use of darunavir/cobicistat alone or darunavir/cobicistat plus dolutegravir and/or rilpivirine adjusted by different HIV patient's characteristics, socio-demographics, HIV severity and use of tenofovir concomitant medication other than antiretrovirals was explored through univariate and multivariate analyses.
Results: The analysis included 725 patients. At 48 weeks, the combination of two or more IPTCrS (darunavir/cobicistat with rilpivirine and/or dolutegravir) was associated with higher decreases in Cr-eGFR [adjusted median difference (±SD) -3.5 ± 1.6 (95% CI -6.6 to -0.3), P = 0.047], and a decrease up to or higher than 15 mL/min/1.73 m2 was more frequent [adjusted OR 3.233 (95% CI 1.343-7.782), P = 0.009], with respect to darunavir/cobicistat alone. The Cr-eGFR changes between darunavir/cobicistat and darunavir/cobicistat with rilpivirine and/or dolutegravir showed more significant decreases in patients taking two or more IPTCrS at 12, 24 and 48 weeks. (ClinicalTrials.gov: NCT03042390).
Conclusions: Concomitant use of darunavir/cobicistat plus IPTCrS dolutegravir, rilpivirine, or both produced an additive effect in the expected Cr-eGFR decrease.
(© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
