Case 30. Problem Solving with New ARVs
Download MP3A 43-year-old man with HIV is virally suppressed on Odefsey. He started Biktarvy 5 years ago but was switched because of headaches. He recently developed worsening kidney function. Listen as Chris Hoffmann of Johns Hopkins and guest Tony Urbina, from the Icahn School of Medicine at Mount Sinai, discuss switching this patient to a newly or soon-to-be approved antiretroviral medication.
References:
References:
- Colson AE, Kumar PN, Ruane PJ, et al. Switch to once-weekly, single-tablet islatravir-lenacapavir from daily standard of care for HIV-1 (ISLEND-2): a multicentre, randomised, open-label, active-controlled, phase 3 non-inferiority trial. Lancet 2026; Aug 29;408(10557):821-832. PMID: 42586113.
- Meissner EG, Ramgopal M, Ruane PJ, et al. Safety and efficacy of switching to bictegravir-lenacapavir versus continuing bictegravir-emtricitabine-tenofovir alafenamide in virologically suppressed people with HIV-1 (ARTISTRY-2): a double-blind, multicentre, randomised, controlled, phase 3, non-inferiority trial. Lancet HIV 2026; Aug;13(8):e538-e547. PMID: 42105781.
- Orkin C, Mngqibisa R, Velez JD, et al. Switch to fixed-dose doravirine (100 mg) and islatravir (0·25 mg) once daily in virologically suppressed adults with HIV-1 on oral antiretroviral therapy: 48-week results of a phase 3, multicentre, randomised, open-label, non-inferiority trial. Lancet 2026; Feb 7;407(10528):599-610. PMID: 41654374.
- Orkin C, Ruane PJ, Hedgcock M, et al. Switch to single-tablet bictegravir-lenacapavir from a complex HIV regimen (ARTISTRY-1): a randomised, open-label, phase 3 clinical trial. Lancet 2026; Mar 28;407(10535):1249-1258. PMID: 41763229.
- Rockstroh JK, Ramgopal MN, Curran Fàbregas A, et al. Phase 3 Trial of Weekly Oral Islatravir-Lenacapavir for HIV-1 Treatment. N Engl J Med 2026; Jul 29. PMID: 42525925.
- Rockstroh JK, Kassim S, Paredes R, et al. Fixed-dose daily doravirine (100 mg) with islatravir (0·25 mg) versus bictegravir, emtricitabine, and tenofovir alafenamide for initial HIV-1 therapy: 48-week results of a phase 3, randomised, controlled, double-blind, non-inferiority trial. Lancet HIV 2026; Jul;13(7):e440-e451. PMID: 41763226.
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