Doravirine/Islatravir: A 2-Drug Regimen for the Treatment of HIV-1 Infection

OBJECTIVE: The objective of this study is to review the efficacy and safety of doravirine/islatravir for the treatment of HIV-1 infection. DATA SOURCES: . Other resources included abstracts presented at recent conferences and the prescribing information. STUDY SELECTION AND DATA EXTRACTION: All English-language studies assessing the efficacy and safety of doravirine/islatravir for the treatment of HIV-1 infection were included. DATA SYNTHESIS: Doravirine is an established second-generation nonnucleoside reverse transcriptase inhibitor. Islatravir is a new nucleoside reverse transcriptase inhibitor that uniquely interferes with translocation and is highly active against HIV-1. Doravirine/islatravir once daily was shown to be safe and effective in three phase 3 clinical trials, using a lower dose of islatravir (0.25 mg), after a higher dose (0.75 mg) was shown in earlier trials to reduce total lymphocyte and CD4+ T-cell counts. The FDA approved this combination for the treatment of HIV-1 infection in adults who are virologically suppressed on stable antiretroviral therapy with no history of virologic treatment failure and no known resistance to doravirine.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Doravirine/islatravir is the first integrase strand transfer inhibitor-free 2-drug regimen indicated for the treatment of HIV-1 infection. The combination could be useful for patients who want to simplify their regimen and those who cannot receive an integrase inhibitor. CONCLUSIONS: Doravirine/islatravir is safe and effective as a 2-drug regimen for the treatment of HIV-1 infection.