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 Conference
"Pairing PI's: A Look at Double Boosting"
Marta Boffito (biography)
English - 2005-04-26 - 46 minutes
(35 slides)
(7 questions)

Summary :
Boosted protease inhibitor (PI) regimens are now in wide use and their benefits are well known. Dr. Marta Boffito explains the rationale for and possible mechanisms of action of so-called double-boosted PI regimens.

Although perhaps not initially evident, as PI’s all have the same target, there is the possibility of a benefit in a host with multiple strains of HIV that may be differentially sensitive to a given PI. However, not all double-boosted PI regimens were created equal!

Dr. Boffito reviews her own group’s pharmacokinetic work and that of other investigators on double-boosted PI regimens in order to determine the most effective PI combinations. Limitations of paired-PI regimens, such as an increased risk for drug-drug interactions and an increased pill burden, are also addressed.

Dr. Boffito concludes her talk with a brief discussion of the interactions between PI’s and antacid medications.

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Learning objectives :
After viewing this presentation, participants will be able to discuss:
- The definition of single- and double-boosted protease inhibitor (PI) regimens
- The rationale for double-boosted PI regimens
- The pharmacokinetics of different double-boosted PI regimens
- The limitations of double-boosted PI regimens, including adverse effects
- The interaction between PI’s and antacid medications

Bibliographic references :
Kilby JM, Sfakianos G, Gizzi N, Siemon-Hryczyk P, Ehrensing E, Oo C, Buss N, Saag MS. Safety and pharmacokinetics of once-daily regimens of soft-gel capsule saquinavir plus minidose ritonavir in human immunodeficiency virus-negative adults. Antimicrob Agents Chemother. 2000 Oct;44(10):2672-8.

Hammer SM, Vaida F, Bennett KK, Holohan MK, Sheiner L, Eron JJ, Wheat LJ, Mitsuyasu RT, Gulick RM, Valentine FT, Aberg JA, Rogers MD, Karol CN, Saah AJ, Lewis RH, Bessen LJ, Brosgart C, DeGruttola V, Mellors JW; AIDS Clinical Trials Group 398 Study Team. Dual vs single protease inhibitor therapy following antiretroviral treatment failure: a randomized trial. JAMA. 2002 Jul 10;288(2):169-80.

Molla A, Mo H, Vasavanonda S, Han L, Lin CT, Hsu A, Kempf DJ. In vitro antiviral interaction of lopinavir with other protease inhibitors. Antimicrob Agents Chemother. 2002 Jul;46(7):2249-53.

Stephan C, Hentig N, Kourbeti I, Dauer B, Mosch M, Lutz T, Klauke S, Harder S, Kurowski M, Staszewski S. Saquinavir drug exposure is not impaired by the boosted double protease inhibitor combination of lopinavir/ritonavir. AIDS. 2004 Feb 20;18(3):503-8.

Boffito M, Dickinson L, Hill A, Back D, Moyle G, Nelson M, Higgs C, Fletcher C, Gazzard B, Pozniak A. Steady-State Pharmacokinetics of Saquinavir Hard-Gel/Ritonavir/Fosamprenavir in HIV-1-Infected Patients. J Acquir Immune Defic Syndr. 2004 Nov 1;37(3):1376-1384.

Boffito M, Kurowski M, Kruse G, Hill A, Benzie AA, Nelson MR, Moyle GJ, Gazzard BG, Pozniak AL. Atazanavir enhances saquinavir hard-gel concentrations in a ritonavir-boosted once-daily regimen. AIDS. 2004 Jun 18;18(9):1291-7.

Boffito M et al 2004. SQV ATV(atazanavir). Pk STUDY of lower dose ATV
Link Name

Boffito et al. 7th ICDTHI 2004.ATV dose comparison in 14 patients
Link Name

Ford J, Boffito M, Wildfire A, Hill A, Back D, Khoo S, Nelson M, Moyle G, Gazzard B, Pozniak A. Intracellular and plasma pharmacokinetics of saquinavir-ritonavir, administered at 1,600/100 milligrams once daily in human immunodeficiency virus-infected patients. Antimicrob Agents Chemother. 2004 Jul;48(7):2388-93.

Boffito M, Maitland D, Dickinson L, Back D, Hill A, Fletcher C, Moyle G, Nelson M, Gazzard B, Pozniak A. Boosted saquinavir hard gel formulation exposure in HIV-infected subjects: ritonavir 100 mg once daily versus twice daily. J Antimicrob Chemother. 2005 Apr;55(4):542-5.

Burger DM, Hugen PW, Kroon FP, Groeneveld P, Brinkman K, Foudraine NA, Sprenger H, Koopmans PP, Hekster YA. Pharmacokinetic interaction between the proton pump inhibitor omeprazole and the HIV protease inhibitor indinavir. AIDS. 1998 Oct 22;12(15):2080-2.

Boffito M, Carriero P, Trentini L, Raiteri R, Bonora S, Sinicco A, Reynolds HE, Hoggard PG, Back DJ, Di Perri G. Pharmacokinetics of saquinavir co-administered with cimetidine. J Antimicrob Chemother. 2002 Dec;50(6):1081-4.

   


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