Impact on Health-Related Quality of Life of a Switch From Enfuvirtide to Raltegravir Among Multidrug-Resistant HIV-1–Infected Patients: A Randomized Open-Label Trial (EASIER-ANRS 138)

Abstract

Background: Among multidrug-resistant HIV-1–infected patients, enfuvirtide has demonstrated sustained efficacy, but long-term use is inconvenient due to twice-daily subcutaneous injections which often induce injection-site reactions. We investigated whether a switch from enfuvirtide to raltegravir, an orally available HIV-integrase inhibitor, may improve health-related quality of life (HRQoL). Methods: 170 multidrug-resistant HIV–1–infected patients who were receiving enfuvirtide-based regimens were randomised to the maintenance of enfuvirtide or the switch to raltegravir at day 0. At week 24, all patients received raltegravir up to week 48. HRQoL was assessed at baseline and weeks 24 and 48 using a self-report MOS-HIV questionnaire. HRQoL scores were compared between arms using analysis of covariance (ANCOVA) models. Results: At week 24, least-squares means changes from baseline for the maintenance and the substitution arms were –5.3 and +5.8 (P = .001) for the pain score, –4.7 and +4.8 (P = .02) for the social functioning score, and –1.3 and +2.0 (P = .003) for the physical summary score, respectively. Conclusion: Among multidrug-resistant HIV-1–infected patients, a switch from enfuvirtide to raltegravir resulted in statistically significant improvements in multiple HRQoL dimensions over 24 weeks in comparison to the maintenance under enfuvirtide.

Keywords:

• health-related quality of life
• raltegravir
• switch