By Tom Rosenthal
Switching their antiretroviral therapy (ART) to a once-daily, single-tablet regimen of bictegravir-emtricitabine-tenofovir alafenamide (BIC/FTC/TAF; Biktarvy, Gilead) proved safe and effective for older HIV-positive adults, according to studies presented at the 2020 virtual International AIDS Conference.
A pooled analysis of four international trials looked at 140 participants who were aged 65 years and older, according Moti Ramgopal, MD, FACP, FIDSA, the medical director at Midway Immunology and Research Center in Fort Pierce, Fla., the lead author who presented the findings. The median age of the participants was 68 years; 14% were women and 88% were white, he added.
At 48 weeks, 92% (129/140) of those who switched to BIC/FTC/TAF maintained virologic suppression, achieving HIV RNA of less than 50 copies/mL, which was the primary end point (oral presentation OAB0403), Dr. Ramgopal said.
“Switching to Biktarvy in older adults was well tolerated and safe while maintaining high rates of virologic suppression through 48 weeks,” Dr. Ramgopal said.
“These data support the use of Biktarvy for the treatment of adults at least 65 years who could benefit from a small tablet with few drug–drug interactions and an established safety profile.”
Adults aged 65 years and older who switched to BIC/FTC/TAF maintained viral suppression without a significant impact on lipid levels, weight or interactions with other drugs they may be taking for comorbidities, according to Dr. Ramgopal.
This was important because many of these older patients had comorbidities: dyslipidemia (59%), hypertension (55%), cardiovascular disease (24%) and diabetes (22%).
In addition, there were no renal, bone or hepatic adverse events (AE) that required discontinuation of the regimen, Dr. Ramgopal said. “There were no serious AEs,” he said. There was a median weight change of 1 kg that plateaued at week 36 of the study, which was consistent with trends in the general population, he added.
“As the number of older adults living with HIV grows, it’s critical to optimize therapy to fit the unique needs of this key population, including those with chronic conditions who may be on multiple medications,” Dr. Ramgopal said. “By 2030, it is projected that up to 70% of people living with HIV will be 50 years or older, the majority of whom will have at least one other comorbidity.”
Dr. Ramgopal reported consulting work with Allergan, Gilead Sciences, Janssen, Merck and ViiV.
