Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir

Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in childr...

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Main Authors: Kulkanya Chokephaibulkit, Maneeratn Nuntarukchaikul, Wanatpreeya Phongsamart, Orasri Wittawatmongkol, Keswadee Lapphra, Nirun Vanprapar, Tim R. Cressey
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/51829
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spelling th-cmuir.6653943832-518292018-09-04T06:13:03Z Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir Kulkanya Chokephaibulkit Maneeratn Nuntarukchaikul Wanatpreeya Phongsamart Orasri Wittawatmongkol Keswadee Lapphra Nirun Vanprapar Tim R. Cressey Medicine Pharmacology, Toxicology and Pharmaceutics Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in children receiving the regimen of lopinavir/ritonavir once daily. Patients and methods: HIV-infected children receiving a twice-daily lopinavir/ritonavir-based regimen and with an HIV-1 RNA viral load (VL) <40 copies/mL for at least 3 months were enrolled. Intensive steady-state 12 h blood sampling for PK assessment was performed at enrolment. Immediately afterwards, the lopinavir/ritonavir dose was changed to once daily with the equivalent daily dose, and intensive steady-state 24 h blood sampling was repeated 2 weeks later. If the lopinavir Ctroughwas <1.0 μg/mL, the lopinavir/ritonavir dose was increased by 20%-30% and Ctroughmeasurement repeated. CD4 cell counts and VL were determined at baseline and at 12, 24 and 48 weeks. Results: Twelve children were enrolled. The median age was 13.1 years. Lopinavir AUC0-24following twice-daily and once-daily dosing was 169.7 (124.0-200.8) and 167.1 (95.1-228.1) · h/mL, respectively. Seven children, including all six concomitantly receiving efavirenz, had a Ctrough<1.0 μg/mL with once-daily lopinavir/ritonavir dosing, and four of seven children had a Ctrough<1.0 μg/mL after dose adjustment. All children maintained virological suppression throughout the 48 week period. Conclusions: Lopinavir/ritonavir-based once-daily regimens could simplify therapy in children/adolescents with virological control, but a lower lopinavir Ctroughwas evident. Further efficacy studies of lopinavir/ritonavir once daily in children are necessary before routinely recommending this dosing strategy. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. 2018-09-04T06:09:59Z 2018-09-04T06:09:59Z 2012-12-01 Journal 14602091 03057453 2-s2.0-84869462249 10.1093/jac/dks332 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84869462249&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/51829
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
Pharmacology, Toxicology and Pharmaceutics
spellingShingle Medicine
Pharmacology, Toxicology and Pharmaceutics
Kulkanya Chokephaibulkit
Maneeratn Nuntarukchaikul
Wanatpreeya Phongsamart
Orasri Wittawatmongkol
Keswadee Lapphra
Nirun Vanprapar
Tim R. Cressey
Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
description Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in children receiving the regimen of lopinavir/ritonavir once daily. Patients and methods: HIV-infected children receiving a twice-daily lopinavir/ritonavir-based regimen and with an HIV-1 RNA viral load (VL) <40 copies/mL for at least 3 months were enrolled. Intensive steady-state 12 h blood sampling for PK assessment was performed at enrolment. Immediately afterwards, the lopinavir/ritonavir dose was changed to once daily with the equivalent daily dose, and intensive steady-state 24 h blood sampling was repeated 2 weeks later. If the lopinavir Ctroughwas <1.0 μg/mL, the lopinavir/ritonavir dose was increased by 20%-30% and Ctroughmeasurement repeated. CD4 cell counts and VL were determined at baseline and at 12, 24 and 48 weeks. Results: Twelve children were enrolled. The median age was 13.1 years. Lopinavir AUC0-24following twice-daily and once-daily dosing was 169.7 (124.0-200.8) and 167.1 (95.1-228.1) · h/mL, respectively. Seven children, including all six concomitantly receiving efavirenz, had a Ctrough<1.0 μg/mL with once-daily lopinavir/ritonavir dosing, and four of seven children had a Ctrough<1.0 μg/mL after dose adjustment. All children maintained virological suppression throughout the 48 week period. Conclusions: Lopinavir/ritonavir-based once-daily regimens could simplify therapy in children/adolescents with virological control, but a lower lopinavir Ctroughwas evident. Further efficacy studies of lopinavir/ritonavir once daily in children are necessary before routinely recommending this dosing strategy. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
format Journal
author Kulkanya Chokephaibulkit
Maneeratn Nuntarukchaikul
Wanatpreeya Phongsamart
Orasri Wittawatmongkol
Keswadee Lapphra
Nirun Vanprapar
Tim R. Cressey
author_facet Kulkanya Chokephaibulkit
Maneeratn Nuntarukchaikul
Wanatpreeya Phongsamart
Orasri Wittawatmongkol
Keswadee Lapphra
Nirun Vanprapar
Tim R. Cressey
author_sort Kulkanya Chokephaibulkit
title Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_short Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_full Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_fullStr Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_full_unstemmed Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_sort once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, hiv-infected, treatment-experienced children: comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84869462249&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/51829
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