Pharmacologic Boosting in 2013 — Is Newer Better?

Maybe — cobicistat is comparable to ritonavir in efficacy, but its lack of intrinsic antiretroviral activity provides an advantage.

Cobicistat — a recently developed cytochrome P450 inhibitor — provides pharmacologic boosting for the integrase inhibitor elvitegravir as part of a single-tablet antiretroviral treatment regimen. Unlike the first such agent, the HIV protease inhibitor (PI) ritonavir, cobicistat has no intrinsic antiretroviral activity, eliminating the risk for conferring HIV PI resistance.

In a recent manufacturer-supported, multinational, randomized, double-blind, double-dummy, active-controlled trial, researchers compared cobicistat with ritonavir as a booster for the PI atazanavir in combination with FTC/tenofovir in 692 treatment-naive HIV-infected adults. At week 48, 85% of cobicistat-group patients and 87% of ritonavir-group patients had viral loads <5…

Reviewing Author

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Pharmacologic Boosting in 2013 — Is Newer Better?

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Reviewing Author