STRIBILD resistance profile through 144 weeks in Studies 103 and 1021,2
Development of drug resistance in adults who had no antiretroviral treatment history (combined results of Studies 103 & 102)1-3
- The most common resistance-associated substitutions that emerged in subjects taking STRIBILD were:1
- RT: M184V/I (n = 17), K65R (n = 5)
- IN: E92Q (n = 9), N155H (n = 5), Q148R (n = 3), T66I (n = 2), and T97A (n =1)a
- All subjects with evaluable data for RT and IN and who developed integrase substitutions associated with EVG resistance (n = 14) also developed the M184V/I RT substitutions, conferring reduced susceptibility to both EVG and FTC
Important Safety Information
BOXED WARNING: LACTIC ACIDOSIS/SEVERE HEPATOMEGALY WITH
STEATOSIS and POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B
- Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including tenofovir disoproxil fumarate (tenofovir DF), a component of STRIBILD, in combination with other antiretrovirals.
- STRIBILD is not approved for the treatment of chronic hepatitis B virus (HBV) infection and the safety and efficacy of STRIBILD have not been established in patients coinfected with HBV and HIV-1. Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HBV and HIV-1 and have discontinued emtricitabine or tenofovir DF, components of STRIBILD. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue STRIBILD. If appropriate, initiation of anti-hepatitis B therapy may be warranted.
STRIBILD is indicated as a complete regimen for the treatment of HIV-1 infection in adults who have no antiretroviral (ARV) treatment history or to replace the current ARV regimen in adults who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable ARV regimen for ≥6 months with no history of treatment failure and no known resistance to any component of STRIBILD.
Please click here for additional Important Safety Information for STRIBILD
- STRIBILD [package insert]. Foster City, CA: Gilead Sciences, Inc; 2014.
- Cohen C, Post F, Winston J, et al. Week 144 renal safety of elvitegravir/ cobicistat/emtricitabine/tenofovir DF (STB) from two phase 3 randomized controlled trials. 20th International AIDS Conference; July 20-25, 2014; Melbourne, Australia. Abstract #WEPE063.
- Clumeck N, Molina JM, Henry K, et al; GS-236-0103 Study Team. A randomized, double-blind comparison of single-tablet regimen elvitegravir/cobicistat/emtricitabine/tenofovir DF vs ritonavir-boosted atazanavir plus emtricitabine/tenofovir DF for initial treatment of HIV-1 infection: analysis of week 144 results. J Acquir Immune Defic Syndr. 2014;65(3):e121-e124.
Please click here to view full Prescribing Information for STRIBILD, including BOXED WARNING
Important Safety Information
Dosage and administration
- Adult dosage: One tablet taken orally once daily with food.
- Renal impairment: Do not initiate in patients with CrCl below 70 mL/min. Discontinue in patients with CrCl below 50 mL/min.
- Hepatic impairment: Not recommended in patients with severe hepatic impairment.
- Testing prior to initiation: Test patients for HBV infection and document baseline CrCl, urine glucose, and urine protein.