Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1

Prina Donga,1 Bruno Emond,2 Carmine Rossi,2 Brahim K Bookhart,1 Johnnie Lee,1 Gabrielle Caron-Lapointe,2 Fangzhou Wei,3 Marie-Hélène Lafeuille2 1Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 2Analysis Group, Inc, Montréal, QC, Canada; 3Analysis Group, Inc, Menlo Park, CA, USACorrespondence:...

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Main Authors: Donga P, Emond B, Rossi C, Bookhart BK, Lee J, Caron-Lapointe G, Wei F, Lafeuille MH
Format: Article
Language:English
Published: Dove Medical Press 2023-07-01
Series:ClinicoEconomics and Outcomes Research
Subjects:
Online Access:https://www.dovepress.com/weight-and-bmi-changes-following-initiation-of-emtricitabinetenofovir--peer-reviewed-fulltext-article-CEOR
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author Donga P
Emond B
Rossi C
Bookhart BK
Lee J
Caron-Lapointe G
Wei F
Lafeuille MH
author_facet Donga P
Emond B
Rossi C
Bookhart BK
Lee J
Caron-Lapointe G
Wei F
Lafeuille MH
author_sort Donga P
collection DOAJ
description Prina Donga,1 Bruno Emond,2 Carmine Rossi,2 Brahim K Bookhart,1 Johnnie Lee,1 Gabrielle Caron-Lapointe,2 Fangzhou Wei,3 Marie-Hélène Lafeuille2 1Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 2Analysis Group, Inc, Montréal, QC, Canada; 3Analysis Group, Inc, Menlo Park, CA, USACorrespondence: Carmine Rossi, Analysis Group, Inc, 1190 Avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC, H3B 0G7, Canada, Tel +1 514-871-4233, Email carmine.rossi@analysisgroup.comIntroduction: Integrase strand transfer inhibitor-based regimens (eg, containing dolutegravir [DTG]) are associated with weight/body mass index (BMI) increases among people living with HIV-1 (PLWH). Assessing antiretroviral therapy (ART)-related weight/BMI changes is challenging, as PLWH may experience return-to-health weight gain as a result of viral suppression. This retrospective, longitudinal real-world study compared weight/BMI outcomes among overweight/obese (BMI ≥ 25 kg/m2; thus excluding return-to-health weight/BMI changes), treatment-naïve PLWH who initiated darunavir (DRV)/cobicistat (c)/emtricitabine (FTC)/tenofovir alafenamide (TAF) or DTG + FTC/TAF.Methods: Treatment-naïve PLWH with BMI ≥ 25 kg/m2 who initiated DRV/c/FTC/TAF or DTG + FTC/TAF (index date) had ≥ 12 months of baseline observation and ≥ 1 weight/BMI measurement in baseline and post-index periods in the Symphony Health IDV® database (07/17/2017– 12/31/2021) were included. Inverse probability of treatment weighting (IPTW) was used to balance differences in baseline characteristics between cohorts. On-treatment time-to-weight/BMI increases ≥ 5% were compared between cohorts using weighted adjusted Cox models.Results: Post-IPTW, 76 overweight/obese DRV/c/FTC/TAF-treated (mean age = 51.2 years, 30.7% female, 35.6% Black, mean baseline BMI = 33.2 kg/m2) and 88 overweight/obese DTG + FTC/TAF-treated PLWH (mean age = 51.5 years, 31.4% female, 31.4% Black, mean baseline BMI = 32.7 kg/m2) were included. The median [interquartile range] time from ART initiation to weight/BMI increase ≥ 5% was shorter for the DTG + FTC/TAF cohort (21.8 [9.9, 32.3] months) than the DRV/c/FTC/TAF cohort (median and interquartile times not reached; Kaplan–Meier rate at 21.8 months = 20.8%). Over the entire follow-up, overweight/obese PLWH initiating DTG + FTC/TAF had a more than twofold greater risk of experiencing weight/BMI increase ≥ 5% compared to those initiating DRV/c/FTC/TAF (hazard ratio [95% confidence interval]=2.43 [1.02; 7.04]; p = 0.036).Conclusion: Overweight/obese PLWH who initiated DTG + FTC/TAF had significantly greater risk of weight/BMI increase ≥ 5% compared to similar PLWH who initiated DRV/c/FTC/TAF and had shorter time-to-weight/BMI increase ≥ 5%, suggesting a need for additional monitoring to assess the risk of weight gain-related cardiometabolic disease.Keywords: human immunodeficiency virus, weight gain, BMI, darunavir, dolutegravir, observational study
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spelling doaj.art-88ff962c8d014fce983eab06f895677f2023-07-25T19:04:49ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812023-07-01Volume 1557959185367Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1Donga PEmond BRossi CBookhart BKLee JCaron-Lapointe GWei FLafeuille MHPrina Donga,1 Bruno Emond,2 Carmine Rossi,2 Brahim K Bookhart,1 Johnnie Lee,1 Gabrielle Caron-Lapointe,2 Fangzhou Wei,3 Marie-Hélène Lafeuille2 1Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 2Analysis Group, Inc, Montréal, QC, Canada; 3Analysis Group, Inc, Menlo Park, CA, USACorrespondence: Carmine Rossi, Analysis Group, Inc, 1190 Avenue des Canadiens-de-Montréal, Tour Deloitte, Suite 1500, Montréal, QC, H3B 0G7, Canada, Tel +1 514-871-4233, Email carmine.rossi@analysisgroup.comIntroduction: Integrase strand transfer inhibitor-based regimens (eg, containing dolutegravir [DTG]) are associated with weight/body mass index (BMI) increases among people living with HIV-1 (PLWH). Assessing antiretroviral therapy (ART)-related weight/BMI changes is challenging, as PLWH may experience return-to-health weight gain as a result of viral suppression. This retrospective, longitudinal real-world study compared weight/BMI outcomes among overweight/obese (BMI ≥ 25 kg/m2; thus excluding return-to-health weight/BMI changes), treatment-naïve PLWH who initiated darunavir (DRV)/cobicistat (c)/emtricitabine (FTC)/tenofovir alafenamide (TAF) or DTG + FTC/TAF.Methods: Treatment-naïve PLWH with BMI ≥ 25 kg/m2 who initiated DRV/c/FTC/TAF or DTG + FTC/TAF (index date) had ≥ 12 months of baseline observation and ≥ 1 weight/BMI measurement in baseline and post-index periods in the Symphony Health IDV® database (07/17/2017– 12/31/2021) were included. Inverse probability of treatment weighting (IPTW) was used to balance differences in baseline characteristics between cohorts. On-treatment time-to-weight/BMI increases ≥ 5% were compared between cohorts using weighted adjusted Cox models.Results: Post-IPTW, 76 overweight/obese DRV/c/FTC/TAF-treated (mean age = 51.2 years, 30.7% female, 35.6% Black, mean baseline BMI = 33.2 kg/m2) and 88 overweight/obese DTG + FTC/TAF-treated PLWH (mean age = 51.5 years, 31.4% female, 31.4% Black, mean baseline BMI = 32.7 kg/m2) were included. The median [interquartile range] time from ART initiation to weight/BMI increase ≥ 5% was shorter for the DTG + FTC/TAF cohort (21.8 [9.9, 32.3] months) than the DRV/c/FTC/TAF cohort (median and interquartile times not reached; Kaplan–Meier rate at 21.8 months = 20.8%). Over the entire follow-up, overweight/obese PLWH initiating DTG + FTC/TAF had a more than twofold greater risk of experiencing weight/BMI increase ≥ 5% compared to those initiating DRV/c/FTC/TAF (hazard ratio [95% confidence interval]=2.43 [1.02; 7.04]; p = 0.036).Conclusion: Overweight/obese PLWH who initiated DTG + FTC/TAF had significantly greater risk of weight/BMI increase ≥ 5% compared to similar PLWH who initiated DRV/c/FTC/TAF and had shorter time-to-weight/BMI increase ≥ 5%, suggesting a need for additional monitoring to assess the risk of weight gain-related cardiometabolic disease.Keywords: human immunodeficiency virus, weight gain, BMI, darunavir, dolutegravir, observational studyhttps://www.dovepress.com/weight-and-bmi-changes-following-initiation-of-emtricitabinetenofovir--peer-reviewed-fulltext-article-CEORhuman immunodeficiency virusweight gainbmidarunavirdolutegravirobservational study
spellingShingle Donga P
Emond B
Rossi C
Bookhart BK
Lee J
Caron-Lapointe G
Wei F
Lafeuille MH
Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
ClinicoEconomics and Outcomes Research
human immunodeficiency virus
weight gain
bmi
darunavir
dolutegravir
observational study
title Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
title_full Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
title_fullStr Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
title_full_unstemmed Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
title_short Weight and BMI Changes Following Initiation of Emtricitabine/Tenofovir Alafenamide Co-Formulated with Darunavir or Co-Administered with Dolutegravir in Overweight or Obese, ART-Naïve People Living with HIV-1
title_sort weight and bmi changes following initiation of emtricitabine tenofovir alafenamide co formulated with darunavir or co administered with dolutegravir in overweight or obese art na iuml ve people living with hiv 1
topic human immunodeficiency virus
weight gain
bmi
darunavir
dolutegravir
observational study
url https://www.dovepress.com/weight-and-bmi-changes-following-initiation-of-emtricitabinetenofovir--peer-reviewed-fulltext-article-CEOR
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