AUTHOR=Hui Liu , Xiaoxu Han , Yuqi Wang , Peng Wang , Xin Wang , Yunyun Yi , Xin Li 

TITLE=Effectiveness and Safety Analysis of PIs/r Based Dual Therapy in Treatment-Naïve, HIV/AIDS Patients: A Network Meta Analysis of Randomized Controlled Trials

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.811357

DOI=10.3389/fphar.2022.811357

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Dual anti-retroviral therapy is the main proven valuable intervention type for treating naïve HIV/AIDS. Currently, no high-quality evidence is available regarding the best dual schemes.</p><p><bold>Objectives:</bold> The aim of this study is to evaluate the effectiveness and safety of PIs/r-based dual therapy in treatment-naïve HIV/AIDS patients by using network meta-analysis.</p><p><bold>Methods:</bold> Randomized controlled trials of PIs/r-based dual therapy in treatment-naïve HIV/AIDS were searched based on Embase, PubMed and Cochrane library database from January 2006 to June 2021. Taking viral suppression rate, CD4<sup>+</sup>T cell count changes from baseline as the primary indicator and adverse events rate as secondary indicator, the network meta-analysis was performed on Review Manager and STATA software. Heterogeneity was assessed by the Q statistic and I<sup>2</sup>. We registered our protocol in Prospero with ID CRD42021275466.</p><p><bold>Results:</bold> Among 15 randomized controlled trials (3,497 patients and 7 PIs/r-based dual therapy) were reviewed in this study. According to the forest map, DRV/r + INSTIs was more effective compared to triple therapy (TT) in viral suppression [OR 0.82, 95% CI (0.61–1.11)], in CD4<sup>+</sup>T cell count changes from baseline [MD 1.9, 95% CI (0.7, 3.1), <italic>I</italic><sup><italic>2</italic></sup> 86%], in adverse events [OR 0.98, 95% CI (0.68–1.39)]. Furthermore, SUCRA ranking analysis indicated that DRV/r + INSTIs was superior to TT in viral suppression (DRV/r + INSTIs 75.5% &gt; TT 41.2%) and in immune construction (DRV/r + INSTIs 67% &gt; TT 42%). In addition, DRV/r + INSTIs was similar to TT in adverse events (DRV/r + INSTIs 54.9% ≈ TT 54.7%).</p><p><bold>Conclusion:</bold> DRV/r + INSTIs was obviously superior to TT in viral suppression and immune reconstruction, and was not higher than TT in adverse events.</p><p><bold>Systematic Review Registration:</bold><ext-link ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="https://www.crd.york.ac.uk/prospero/">https://www.crd.york.ac.uk/prospero/</ext-link>, identifier CRD42021275466</p>