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29 Jul 2020
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11 Aug 2020
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Jairia Dela Cruz, 18 Feb 2020
Administering daily oral doses of adjunctive perampanel is safe and well tolerated in the treatment of young and older children with focal seizures or generalized tonic‐clonic seizures, in addition to yielding about 40–70 percent reduction in seizure frequency, according to data from the open-label 311 Core Study.
23 Apr 2018
Long‐term treatment with perampanel in the adjunctive setting appears to provide improved seizure control without raising new safety/tolerability signals in patients with epilepsy, particularly those with secondarily generalized seizures at baseline, according to the results of an open-label extension of phase III trials.

Monthly cabotegravir-rilpivirine favoured by PLHIV

Audrey Abella
05 Aug 2019

Persons living with HIV (PLHIV) who received monthly long-acting (LA) intramuscular formulations of the INSTI* cabotegravir and the NNRTI** rilpivirine reported higher levels of treatment satisfaction and treatment acceptance, ­and greater willingness to continue therapy as opposed to a daily oral antiretroviral therapy (ART) regimen, according to patient-reported outcomes of the ATLAS*** and FLAIR# trials presented at IAS 2019.

In ATLAS, 616 individuals (median age 42 years, 33 percent female) who were virologically suppressed for >6 months on an oral regimen## were randomized 1:1 to either switch to monthly LA cabotegravir 400 mg plus rilpivirine 600 mg (C+R) after a lead-in phase with oral C+R once daily for 4 weeks, or to continue their current daily oral ART regimen. [IAS 2019, abstract MOAB0103]

After adjusting for baseline score, age, sex, race, and third agent class at week 44, participants in the C+R arm reported better treatment satisfaction than those in the ART arm (adjusted mean change, 5.68, 95 percent confidence interval [CI], 4.37–6.98; p<0.001).

Treatment acceptance rate was also better with C+R vs ART at week 48 (adjusted mean change, 10.7, 95 percent CI, 7.1–14.4; p<0.001), with majority of the C+R recipients rating their injection site reactions (ISRs) as ‘totally’ or ‘very’ acceptable (90 percent and 86 percent, respectively). Only 1 percent of those who had ISRs withdrew from treatment.

Overall, 94 percent and 66 percent of participants in the C+R and ART arms, respectively, noted that they were ‘satisfied to continue treatment’. Almost all participants (97 percent) in the overall cohort preferred LA treatment over daily ART, translating to a high level of treatment satisfaction, noted the researchers.

The maintenance phase of FLAIR included 566 participants (median age 34 years, 22 percent female) who achieved HIV-1 RNA <50 c/mL at week 16. Subjects were randomized 1:1 to either transition to an injectable LA C+R regimen as in ATLAS or continue oral induction therapy comprising dolutegravir/abacavir/lamivudine (DTG/ABC/3TC). [IAS 2019, abstract MOPEB258]

At week 48, C+R recipients reported greater improvement in treatment satisfaction vs those who remained on DTG/ABC/3TC (adjusted mean change, 4.1, 95 percent CI, 2.8–5.5; p<0.001).

Week 48 also saw a reduction in the frequency of ISRs in the C+R arm from baseline (from 71 percent to 20 percent), with a greater fraction of participants rating the ISRs as ‘totally’ or ‘very’ acceptable (55 percent and 31 percent, respectively). Statistically significant improvements in mean PIN### ‘Acceptability of ISRs’ dimension scores were noted from week 5 to weeks 41 and 48 (from 2.08 to 1.71 [p<0.001] and 1.66 [p<0.001], respectively).

With 99 percent of the overall cohort preferring C+R over their prior oral regimen, the FLAIR findings likewise reflected a clear preference for monthly injectable formulations despite the necessary clinic visits, noted the researchers.

Taken together, the high level of overall acceptability observed in both ATLAS and FLAIR trials suggests that the LA C+R regimen met subjects’ expectations. Investigators of both trials concur that the findings support the therapeutic potential of monthly LA C+R for virologically suppressed PLHIV seeking an alternative to daily oral regimens, which could facilitate or even improve treatment adherence and enhance convenience while reducing dosing frequency.

 

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Most Read Articles
29 Jul 2020
Adjunctive perampanel appears to be safe and effective for long-term treatment of patients with tonic‐clonic seizures, according to a posthoc analysis.
11 Aug 2020
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Jairia Dela Cruz, 18 Feb 2020
Administering daily oral doses of adjunctive perampanel is safe and well tolerated in the treatment of young and older children with focal seizures or generalized tonic‐clonic seizures, in addition to yielding about 40–70 percent reduction in seizure frequency, according to data from the open-label 311 Core Study.
23 Apr 2018
Long‐term treatment with perampanel in the adjunctive setting appears to provide improved seizure control without raising new safety/tolerability signals in patients with epilepsy, particularly those with secondarily generalized seizures at baseline, according to the results of an open-label extension of phase III trials.