BATAR (Boosted Atazanavir Truvada vs. Atazanavir Raltegravir)
CRI continually evaluates new drugs and combinations of drugs not only to make sure they are effective at treating HIV, but to find ways to reduce the possibility of short- and long-term side effects. The more medications a patient takes, the greater the risk of toxicity and other undesirable drug-related health concerns. HIV treatment most often consists of three-drug combinations, but can two-drug combinations provide comparable results?
In 2011, CRI developed a national, investigator-initiated study, BATAR (Boosted atazanavir Truvada vs. atazanavir raltegravir) to answer this critical question. It studied the safety, tolerability, and effectiveness of reducing the number of drugs a patient takes.
BATAR evaluated whether switching from the three-drug combination of atazanavir/ritonavir/Truvada to the two-drug combination of atazanavir and raltegravir would be safe and effective, while reducing negative drug-related health effects. CRI researchers developed this study because the combination of atazanavir and raltegravir is known to have potent antiviral activity. They asked the question: Will these two drugs maintain control of HIV—and if so, could this be an option for those experiencing side effects on other drug combinations?
In this study, the use of boosted atazanavir with either Truvada or raltegravir was similarly successful over 48 weeks in maintaining virologic suppression.
However, unboosted twice-daily atazanavir with twice-daily raltegravir raised several concerns. The data supports the continuation of Truvada with atazanavir/ritonavir when tolerated; replacing Truvada with raltegravir maintained suppression in this pilot though an increased number of neurologic events was observed. The use of twice-daily atazanavir instead of atazanavir/ritonavir is not recommended for use based on the observations in this pilot.
The BATAR study enrolled 43 participants from 9 states in 10 different study sites. Click here for the abstract and here for a complete data summary of the BATAR study, which Dr. Cohen presented at the 11th International Congress on Drug Therapy in HIV Infection in 2012.