TY - JOUR
T1 - When food can make the difference
T2 - The case of elvitegravir-based co-formulation
AU - Cattaneo, Dario
AU - Baldelli, Sara
AU - Minisci, Davide
AU - Meraviglia, Paola
AU - Clementi, Emilio
AU - Galli, Massimo
AU - Gervasoni, Cristina
PY - 2016/10/15
Y1 - 2016/10/15
N2 - Stribild should be administered under fed conditions to optimize drugs exposure. Here we assessed to what extent this advice is applied in the real life scenario by therapeutic drug monitoring in 75 HIV-infected patients given Stribild-based antiretroviral therapy. Fifty-three percent of our patients took Stribild at lunch/supper time, 23% in the morning with breakfast, and 24% middle in the morning or late in the evening. Twelve out of the 75 patients had unquantifiable elvitegravir concentrations, whereas in the remaining the levels were largely distributed. Wide inter-individual variability in the tenofovir, cobicistat and darunavir trough concentrations was also observed. In real life settings a significant proportion of patients took Stribild without food, namely in the mid-morning or late in the evening. This resulted in a wide inter-individual variability of antiretroviral drug trough concentrations. To avoid the risk for patients to experience suboptimal drug exposure, it is important that health professionals more convincingly advise their patients to take Stribild in fed conditions. On the other hand, the role of patient education and patient responsibility to correctly take the therapy should not be underestimated.
AB - Stribild should be administered under fed conditions to optimize drugs exposure. Here we assessed to what extent this advice is applied in the real life scenario by therapeutic drug monitoring in 75 HIV-infected patients given Stribild-based antiretroviral therapy. Fifty-three percent of our patients took Stribild at lunch/supper time, 23% in the morning with breakfast, and 24% middle in the morning or late in the evening. Twelve out of the 75 patients had unquantifiable elvitegravir concentrations, whereas in the remaining the levels were largely distributed. Wide inter-individual variability in the tenofovir, cobicistat and darunavir trough concentrations was also observed. In real life settings a significant proportion of patients took Stribild without food, namely in the mid-morning or late in the evening. This resulted in a wide inter-individual variability of antiretroviral drug trough concentrations. To avoid the risk for patients to experience suboptimal drug exposure, it is important that health professionals more convincingly advise their patients to take Stribild in fed conditions. On the other hand, the role of patient education and patient responsibility to correctly take the therapy should not be underestimated.
KW - Cobicistat
KW - Darunavir
KW - Elvitegravir
KW - Food
KW - Tenofovir
KW - Therapeutic drug monitoring
UR - http://www.scopus.com/inward/record.url?scp=84985040958&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84985040958&partnerID=8YFLogxK
U2 - 10.1016/j.ijpharm.2016.08.063
DO - 10.1016/j.ijpharm.2016.08.063
M3 - Article
AN - SCOPUS:84985040958
VL - 512
SP - 301
EP - 304
JO - International Journal of Pharmaceutics
JF - International Journal of Pharmaceutics
SN - 0378-5173
IS - 1
ER -