Il 6 Ottobre sono state pubblicate le nuove linee guida americane per l’utilizzo della terapia antiretrovirale in adulti ed adolescenti: varie novità tra cui tipranavir, TMC 114. Bocciato il regime tenofovir + didanosina + NNRTI nei pazienti naive.
Non raccomandato il tipranavir nei pazienti naive. Inserito il tipranavir con o senza enfuvirtide per i pazienti in fallimento terapeutico.
Compare il TMC 114 in expanded access program.
The “Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents” document has been revised to include the following changes:
What Not to Use as Initial Therapy (Table 8)
The Panel recommends that a regimen containing “NNRTI + didanosine + tenofovir” should not be used as an initial regimen in antiretroviral treatment-naïve patients due to reports of early virologic failure and rapid emergence of resistant mutations to NNRTIs, tenofovir, and/or didanosine.(DII)
The Panel does not recommend the use of ritonavir-boosted tipranavir in treatment-naïve patients due to the lack of clinical trial data in this setting.(DIII)
Management of Treatment Experienced Patients
This section has been updated to redefine the goal of antiretroviral therapy in the management of treatment-experienced patients with virologic failure and to review the role of more potent ritonavir-boosted protease inhibitors such as tipranavir with or without enfuvirtide in these patients.
Tables 23-25 have been updated to be consistent with the revised text.
The Following Tables Have Been Updated:
Table 7 – Treatment outcome data of once daily abacavir-lamivudine and lopinavir-ritonavir have been added to this table.
Tables 12 & 13 – These tables have been updated with information on once daily lopinavir-ritonavir dosing and new information on characteristics of tipranavir.
Tables 16-21b – These tables have been updated to include information relating to tipranavir-associated adverse events and drug interactions.
Tables 23-25 – These tables are updated to be consistent with the revised text on the management of treatment-experienced patients.
Table 26 – Suggested minimum target trough concentration for atazanavir has been added to this table.
Tables 28 & 29 – These tables are adapted from the USPHS perinatal antiretroviral guidelines with information on tipranavir use during pregnancy.
Table 30 – This table has been updated with information for TMC-114 Expanded Access Program. Information regarding tipranavir expanded access program has been removed.
Linee guida in formato PDF: