Resumen de Simplificación del tratamiento antirretroviral con darunavir potenciado con ritonavir en monoterapia
Luis González Rivas, Ernesto Sánchez Gómez, Raquel Sánchez del Moral, Emilio Pujol de la Llave
Objective: MONET and MONOI-ANRS136 studies have shown the effectiveness of darunavir monotherapy boosted with ritonavir. The main objective of this study is to analyze the effectiveness of this therapeutic strategy in healthcare clinical practice. As a secondary objective, we evaluated the drug's safety, adherence and generated savings. Method: Descriptive observational study. The main variable of effectiveness was defined as the value of the plasma viral load. As secondary variables for effectiveness, we defined the immune and clinical response variables. Other variables were safety, adherence and cost savings. The statistical data analysis was descriptive. Results: We identified 36 patients under treatment, and included 23. Viral load remained undetectable, except for one patient in week 12, and 4 patients in week 24. The numbers of CD4 lymphocytes remained above 400 cells/µl. No unexpected infections or AIDS-related neoplasias appeared in any patient. The observed adverse reactions were not serious. All reactions were classified as defined, except for grade I constipation, which was classified as possible. 21.74% of patients overcame adherence by more than 95%. We saved an average of 2,825.25 per month of treatment. The replacement of tenofovir/ emtricitabine + saquinavir + ritonavir by monotherapy contributed to 28.95% of total savings. Conclusions: Monotherapy could be a therapeutic alternative for certain patients. Darunavir in monotherapy is a safe and well-tolerated drug. The treatment has proven to be effective despite low adherence, and the use of this strategy proved to reduce the cost of treatment for the health system
