Discontinuation Rates for Protease Inhibitor Regimens Containing Ritonavir 600 mg versus Ritonavir 400 mg Plus Saquinavir 400 mg

Abstract

Spanish

French

OBJECTIVE:

A retrospective study was performed to determine whether twice-daily ritonavir 400 mg plus twice-daily saquinavir 400 mg (ritonavir 400/saquinavir 400) was better tolerated than ritonavir 600 mg twice daily (ritonavir 600). A secondary objective was to determine whether the rate of discontinuation due to therapeutic failure differed between the two ritonavir regimens.

DESIGN:

The study was a retrospective chart review. Data collected included ritonavir dose; length of ritonavir therapy; reason for discontinuation; HIV-1 RNA prior to and at discontinuation of ritonavir therapy; CD4+ count; and antiretroviral therapy prior to, concomitant with, and initiated after ritonavir therapy.

SETTING:

Patient charts were reviewed in a university teaching hospital clinic.

PATIENTS:

Patients were identified through a search of the pharmacy database from December 18, 1995, to December 18, 1997. Patients were >18 years old, but not restricted by gender or race.

MAIN OUTCOME MEASURES:

The main outcome measures were frequency of discontinuation of ritonavir due to intolerance or due to lack of therapeutic efficacy.

RESULTS:

The search identified 116 patients, including 57 patients taking ritonavir 400/saquinavir 400 and 54 patients taking ritonavir 600. Five patients on other ritonavir regimens were excluded. Significantly fewer patients receiving ritonavir 400/saquinavir 400 (14%) discontinued ritonavir due to intolerance compared with ritonavir 600 (37%; p = 0.002). Discontinuations due to therapeutic failure were not significantly different: 8.8% for ritonavir 400/saquinavir 400 and 7.4% for ritonavir 600, despite the fact that ritonavir/saquinavir therapy followed another protease inhibitor in 41 patients (73.2%) compared with 12 patients (24.5%) for ritonavir 600 (p = 0.001).

CONCLUSIONS:

Ritonavir 400/saquinavir 400 is better tolerated than ritonavir 600.

Keywords

ritonavir saquinavir discontinuation

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