Efficacy and safety of doravirine/islatravir for HIV-1: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.
Hamzah M Alghzawi, Syed Zohad Shah, Zain Ul Abideen et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of the doravirine/islatravir (DOR/ISL) regimen for HIV-1 in 3,600 participants across seven randomized controlled trials. At week 48, DOR/ISL demonstrated non-inferior virological suppression rates compared to active controls (RR 1.01) and a significant reduction in virological failure risk (RR 0.55).
Key findings
- DOR/ISL achieved non-inferior suppression rates at week 48 (RR 1.01; p = 0.516).
- DOR/ISL showed a statistically significant reduction in virological failure risk (RR 0.55; p = 0.022).
- The 0.75 mg dose of islatravir was associated with significant CD4+ declines, while the 0.25 mg dose was immunologically neutral.
- DOR/ISL was weight-neutral compared to standard ART (MD -0.25 kg).
Why it matters
The findings suggest that DOR/ISL is a viable treatment option for HIV-1, offering comparable efficacy to standard ART while addressing previous safety concerns through dose optimization. This could influence treatment strategies for both treatment-naïve and virologically suppressed patients.