Combination therapies, effectiveness, and adherence in patients with HIV infection: clinical utility of a single tablet of emtricitabine, rilpivirine, and tenofovir

Figures & data

Table 1 Summary data from the ECHO and THRIVE Phase III studies

	THRIVE		ECHO		Combined information
	EFV	RPV	EFV	RPV	EFV	RPV
Number of patients	340	340	344	346	682	686
Virologic failures (%)	5	7	6	13	9	13
Virologic response (48 weeks) (%)	82	86	83	83	82	84
CD4 count increase (48 weeks)	263	263	257	240

Abbreviations: EFV, efavirenz; RPV, rilpivirine.

Table 2 Frequently detected resistance mutations in the Pooled ECHO and THRIVE Phase III trials

	RPV arm	EFV arm
NRTI or N(t) RTI mutations
Most frequent	M184I	M184V
Less frequent	M184V, K219E, K65R, Y115F, K65N, A62V	M184I, K65R
NNRTI mutations
Most frequent	E138K	K103N
Less frequent	K101E, H221Y, V90IY181C, V189I, L100I, V179I, E138Q, F227C	V106M, Y188C, K101E, L100I

Abbreviations: RPV, rilpivirine; EFV, efavirenz; NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; N(t) RTI, nucleotide reverse transcriptase inhibitor.

Table 3 Important RPV drug-drug Interactions

Drug	Recommendation	Levels of RPV plasma concentration	Mechanism
Antacids	Caution advised	⇓	Increase gastric pH and reduce absorption
Azole antifungals	Caution advised	⇑	Inhibit CYP3A
HIV protease inhibitors	Caution advised	⇑	Inhibit CYP3A
HCV protease inhibitors	Caution advised	⇑	Inhibit CYP3A
H2-receptor antagonists	Caution advised	⇓	Increase gastric pH and reduce absorption
Anticonvulsants	Contra-indicated	⇓	Induce CYP3A
Proton pump inhibitors	Contra-indicated	⇓	Increase gastric pH and reduce absorption
Dexamethasone	Contra-indicated	⇓	Induces CYP3A
NNRTIs	Contra-indicated	⇓/⇑	Induce/inhibit CYP3A
Rifamycins	Contra-indicated	⇓	Induce CYP3A
Macrolides	Contra-indicated	⇑	Inhibit CYP3A

Abbreviations: RPV, rilpivirin; NNRTIs, non-nucleoside reverse transcriptase inhibitor; HCV, hepatitis C virus; HIV, human immunodeficiency virus.