Will Dolutegravir Instantly Become the Integrase Inhibitor of Choice in Patients with Treatment Failure?

In a recent randomized, double-blind trial involving treatment-experienced patients at 156 sites, virologic outcomes were better with dolutegravir than with raltegravir. In addition, dolutegravir is taken only once daily (vs. twice with raltegravir), seems just as well tolerated, has a similar drug–drug interaction profile, and is probably less prone to resistance. In HIV and ID Observations, Dr. Paul Sax predicts that, barring unexpected toxicity when the drug gets into broader use after approval, dolutegravir will quickly become the integrase inhibitor of choice in patients with treatment failure.