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: