HIV Associated Neurocognitive Disorder Clinical Trial
Official title:
Effect of SwitChing AtriPla to Eviplera on Neurocognitive and Emotional Functioning, ESCAPE Study
This study will evaluate the effects of switching Atripla to Eviplera on neurocognition measured by neuropsychological testing and functional MRI
Efavirenz, an antiretroviral drug used for the treatment of human immunodeficiency virus 1
(HIV-1) infections, is known for its neurological and psychiatric adverse events. Efavirenz
is part of Atripla®, a single tablet regimen (STR), currently the most prescribed
antiretroviral drug in the Netherlands. Recently, a new STR has become available, Eviplera®
containing a successor of Efavirenz, named Rilpivirin. It has been shown in the phase-3 ECHO
and THRIVE studies that Atripla as well as Eviplera have excellent and comparable
antiretroviral efficacy in naive HIV-infected patients. Furthermore, data from these studies
have shown that Eviplera was associated with fewer neurological and psychiatric adverse
events than Atripla over 48 weeks. However, this was only patient reported adverse events,
not neuropsychological evaluation. Furthermore, they were treatment naïve for HIV. Moreover,
there might be a bias in these kind of switch studies due to the fact that those patients who
switch will mostly regard their new combination better than the old one. Contrary, data on
the long term impact of Efavirenz on neuropsychological performance and symptoms are
conflicting.
Objective: This study aims to investigate the effect of switching from Atripla to Eviplera on
neurocognitive performances (neurocognitive testing) and imaging (functional MRI scanning) in
virologically suppressed HIV-infected patients.
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