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AIDS and HIV Information

AIDS and HIV Information

Triumeq vs Atripla

Triumeq vs Atripla


In the recently updated HIV guidelines from the Department of Health and Human Services (DHSS), Triumeq is included as a recommended initial regimen for most people, while Atripla is part of the recommended initial regimens in certain clinical situations. This means Triumeq can be prescribed as a first-line treatment for HIV, and Atripla can be used as an alternative treatment if the patient’s condition calls for it. The second group of recommended drugs are still effective and tolerable, but they have some disadvantages compared to the group of first-line treatments. Additionally, there may be less data from randomized clinical trials that support their safety in terms of long-term use.

Triumeq by ViiV Healthcare

Triumeq is a once-daily single-tablet regimen (STR) that contains an integrase inhibitor (INSTI) called dolutegravir and two nucleoside reverse transcriptase inhibitors (NRTI) called abacavir and lamivudine. These drugs are also available individually and can be prescribed together with other antiretroviral meds to suppress HIV-1 infection in adults and adolescents. This combination treatment is recommended as a first-line treatment for treatment-naïve patients, which are those who have not received antiretroviral therapy (ART) in the past, because of its high-potency and well-tolerated side effects. However, the abacavir component of Triumeq may cause hypersensitivity reactions, therefore, patients must be screened for the HLA-B*5701 gene before they can receive the treatment. Most INSTI-based regimens require an additional booster to keep the drugs longer in the body. However, there’s a long list of drugs that may interact with boosters, and one of these is cobicistat. One of the advantages of Triumeq is that, while it contains the INSTI dolutegravir, it does not require a booster, so there are fewer drug interactions with this regimen.

Atripla by Gilead Sciences and Bristol-Myers Squibb

In 2006, Gilead Sciences and Bristol-Myers Squibb made an agreement to market the combination of efavirenz (Sustiva), emtricitabine, and tenofovir disoproxil fumarate (Truvada) as Atripla. This joint venture made Atripla the first complete single-tablet product approved for use in treating HIV infections. Atripla was downgraded as an alternative treatment due to its higher rates of side effects in contrast to other regimens containing dolutegravir, elvitegravir, and cobicistat. In one study comparing Atripla and Complera, patients reported better mental health with Complera but experienced improved physical health with Atripla.

Triumeq vs Atripla Comparison Chart

TRIUMEQ
(dolutegravir/abacavir/lamivudine)

ATRIPLA
(efavirenz/emtricitabine/tenofovir disoproxil fumarate)

Approval Date

August 22, 2014

July 12, 2006

Indications

For HIV-infected adults and children 12 years of age and older weighing at least 40 kilograms (88 pounds). Must test negative for the HLA-B*5701 allele.

For HIV-infected adults and children 12 years of age and older weighing at least 40kg.

Half-Life

  • Dolutegravir: 14 hours
  • Abacavir: 1.5 hours
  • Lamivudine: 15–16 hours

 

  • Efavirenz – 40–55 hours
  • Emtricitabine – 10 hours
  • Tenofovir disoproxil fumarate – 17 hours

Dosage

Oral tablet containing 600mg dolutegravir, 50mg abacavir, and 300mg lamivudine

Oral tablet containing 600mg efavirenz, 200mg emtricitabine, and 300mg tenofovir disoproxil fumarate

Advantages

  • Included in the recommended list of HIV treatment regimens
  • Not affected by food intake
  • More convenient than other regimens, as it contains three drugs in one tablet
  • Fewer drug interaction compared to booster-containing meds
  • Convenient for its dosage of one pill a day
  • Assistance programs are available from the government and manufacturer
  • Fewer drug interactions compared to booster-containing meds
  • Can be used alone or combined with other antiretroviral agents

Disadvantages

  • If you are a smoker, hypertensive, diabetic, and/or have high cholesterol, this may increase your risk of heart attack
  • Not recommended for people with severe liver and kidney impairment
  • May trigger hypersensitivity reactions; screening is required prior to treatment
  • May cause abnormal dreams, anxiety, or depression
  • Should be taken at bedtime to control side effects
  • Not recommended for patients with poorly functioning kidneys
  • Not recommended for pregnant and lactating women or those who are planning to conceive
  • May worsen bone loss or osteoporosis
  • Associated with suicidality

Side Effects

  • Nausea
  • Insomnia
  • Headache
  • Fatigue
  • Diarrhea
  • Dizziness
  • Nausea
  • Headache

Risk Factors

  • Obesity
  • Being a woman
  • Worsening of Hepatitis B or C infection
  • Liver problems
  • Lactic acidosis
  • Enlarged fatty liver
  • Hypersensitivity reactions
  • Being a woman
  • Obesity
  • Liver problems
  • Hepatitis B infection
  • Lactic acidosis
  • High kidney and bone toxicity
  • Psychiatric and nervous system problems

Cost

Starts at $2,700 for a 30-tablet bottle

Starts at $2,700 for a 30-tablet bottle

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