A treatment regimen anchored by doravirine worked as well as a dolutegravir-based approach but led to significantly less weight gain among patients starting antiretroviral therapy (ART) for HIV, an open-label randomized trial showed.
Among 600 treatment-naive patients in South Africa, 89% of those who took once-daily doravirine, lamivudine, and tenofovir disoproxil fumarate (Delstrigo) achieved HIV RNA levels of less than 50 copies/mL at 48 weeks compared with 90.7% of those taking once-daily dolutegravir, emtricitabine, and tenofovir alafenamide, meeting the prespecified noninferiority margin of -10 percentage points.
Both regimens were linked with weight gain, but the median weight gain was lower with the doravirine-anchored regimen: 3.0 kg versus 5.0 kg with the dolutegravir-based approach (P<0.001), reported Joana Woods, MBChB, MPH, of the University of the Witwatersrand in Johannesburg, at the International AIDS Conference in Rio de Janeiro.
The study results were also published simultaneously in JAMA.
The doravirine-based regimen isn't a universal ART replacement, Woods cautioned. But the findings support this alternative regimen to prevent weight gain and potentially modify cardiometabolic risk, she said.
