Evolution of Self-reported Neuropsychiatric Symptoms After Switching from Dolutegravir/Abacavir/Lamivudine to Bictegravir/Emtricitabine/Tenofovir Alafenamide: Results from the Randomized DOBINeuro Trial

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2024年11月29日

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Barbara Rossetti,
Micol Ferrara,
Lucia Taramasso,
Francesca Bai,
Francesca Lombardi,
Nicoletta Ciccarelli,
Miriam Durante,
Francesca Alladio,
Federica Bonazza,
Ilaria Rancan,
Francesca Montagnani,
Antonio Di Biagio,
Antonella d’Arminio Monforte,
Maurizio Zazzi,
Massimiliano Fabbiani,
Andrea De Luca,
Alessandro Lanari,
Melissa Masini,
Giacomo Zanelli,
Sabrina Bianchi,
Nicola Giovanni Girtler,
Federica Miraglia,
Federica De Flaviis,
Simona Di Giambenedetto,
Silvia Lamonica,
Stefano Bonora,
Laura Trentini

摘要

Introduction

Central nervous system adverse events (AE) have been a cause of discontinuation of dolutegravir-containing therapy, especially in combination with abacavir. The main aim of the study was to evaluate whether the switch to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) was associated with a reduction in severity and incidence of neuropsychiatric symptoms compared to continued dolutegravir/abacavir/lamivudine (DTG/ABC/3TC).

Methods

DOBINeuro is a randomized trial enrolling people living with HIV (PLWH) treated with DTG/ABC/3TC for > 6 months and with HIV-RNA < 50 cps/ml for > 12 months. At baseline, PLWH are randomized to continue DTG/ABC/3TC or switch to BIC/FTC/TAF. The original sample size was 50 PLWH per arm, but the enrollment was prematurely stopped due to a delayed recruitment process. Neuropsychiatric symptoms were evaluated by the self-report Symptom Checklist (SCL)-90-R and the Mini-International Neuropsychiatric Interview Plus.

Results

A total of 41 PLWH were enrolled and underwent randomization: 20 were randomized to continue DTG/ABC/3TC and 21 to switch to BIC/FTC/TAF. At baseline, clinical and laboratory characteristics were homogeneous in the two arms. Switching from DTG/ABC/3TC to BIC/FTC/TAF in virologically suppressed PLWH was associated with an improvement in sleep disorders but not in any other neuropsychiatric symptom.

Conclusions

Although limited by a low sample size, this study suggests neuropsychiatric tolerability may improve when switching virologically suppressed PLWH from DTG to BIC-based strategies.