Genvoya Vs. Triumeq
One of the key milestones in the field of HIV medications is the introduction of single-tablet regimen (STR) in 1996. Standard antiretroviral therapy (ART) has evolved since then. The Department of Health and Human Services recommend the combination of three or more medications from at least 2 different drug classes for a complete HIV-1 antiretroviral regimen. Triumeq and Genvoya are two STRs approved as initial antiretroviral treatment for most people. Both are highly potent against HIV but each may have their own associated risks and disadvantages.
Triumeq (dolutegravir/abacavir/lamivudine)
Triumeq is developed and manufactured by ViiV Healthcare, an HIV company established by GlaxoSmithKline and Pfizer. This regimen is the only single-tablet medication with an abacavir/lamivudine (Epzicom) nucleoside backbone. It is only recommended for patients who test negative to the HLA-B*5701 gene. Unlike Genvoya’s elvitegravir, Triumeq contains the integrase inhibitor dolutegravir, which does not require a booster. This means Triumeq has fewer side effects and possible drug interactions than Genvoya. But, its active ingredient abacavir may cause hypersensitivity reactions, hence the initial HLA-B*5701 testing requirement. Additionally, there are studies linking abacavir with increased heart attack risk, so people with heart disease or several risk factors for heart disease must avoid abacavir-containing meds.
Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide)
This regimen is the improved version of Stribild (elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate). The old prodrug tenofovir disoproxil fumarate (TDF) in many STRs is replaced by tenofovir alafenamide (TAF) in Genvoya. The downside of Genvoya is the booster cobicistat that may interact with a long list of medications, such as statins, birth control pills, nasal corticosteroids, and erectile dysfunction drugs, just to name a few. The amount of tenofovir is also reduced in this drug, from 300mg to 10mg. In theory, it could mean less amount of the drug stays in the bloodstream to cause potential adverse events (e.g., kidney and bone toxicity).
Triumeq vs Genvoya: side by side comparison
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GENVOYA |
TRIUMEQ |
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Manufacturer |
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Gilead Sciences |
ViiV Healthcare |
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Approval Date |
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| November 5, 2015 | August 22, 2014 |
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Indications |
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| Included in the HHS guidelines as first-line treatment regimen for HIV-infected adults and adolescents 12 years of age and older, weighing at least 35 kilograms (77 pounds) | Included in the HHS guidelines as first-line treatment regimen for HIV-infected adults and children 12 years of age and older, weighing at least 40 kilograms (88 pounds) |
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Biological Half-Life |
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Dosage |
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| Oral tablet containing 150mg elvitegravir, 150mg cobicistat, 10mg tenofovir alafenamide fumarate, and 200mg emtricitabine | Oral tablet containing 600mg dolutegravir, 50mg abacavir, and 300mg lamivudine |
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Advantages |
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Disadvantages |
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Side Effects |
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Risk Factors |
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Cost |
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| Starts at $2900+ for a 30-tablet bottle | Starts at $2700+ for a 30-tablet bottle |
Despite the big leaps that pharmaceutical companies and healthcare providers have accomplished to improve the life expectancy of HIV-infected patients, there is still no cure for the dreaded disease. Still, pharmacological therapies have come a long way; Triumeq and Genvoya, for example, have high success rate of up to 90%. If you’re still using the old, previously recommended regimens like Stribild and Atripla, it might be time to discuss with your healthcare team if a switch to newer, less toxic regimens would be beneficial. Even patients who are having well tolerated side effects from their current regimen may feel better using the latest antiretroviral meds.
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