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Efficacy and safety of switching to dolutegravir/lamivudine fixed-dose two-drug regimen vs continuing a tenofovir alafenamide–based three- or four-drug regimen for maintenance of virologic suppression in adults with HIV-1: Phase 3, randomized, non-inferiority TANGO study

Clinical Infectious Diseases Jan 16, 2020

van Wyk J, Ajana F, Bisshop F, et al. - For treatment-naive adults with HIV-1, the 2-drug regimen (2DR) dolutegravir (DTG) + lamivudine (3TC) is indicated. Via the present work, researchers examined the efficacy and safety of switching to DTG/3TC in virologically suppressed individuals. They conducted TANGO, an open-label, multicenter, phase III study, randomizing adults (1:1, stratified by baseline third agent class) with HIV-1 RNA < 50 copies/mL to either switch to a once-daily DTG/3TC fixed-dose combination or remain on a tenofovir alafenamide (TAF)-based regimen. Enrollment of 743 adults was done; of these, 741 took ≥ 1 dose of study drug (DTG/3TC, N = 369; TAF-based regimen, N = 372). Outcomes suggest non-inferiority of the 2DR DTG/3TC to a TAF-based regimen in maintaining virologic suppression at Week 48; no virologic failure or emergent resistance was reported in the DTG/3TC group. This supports its use as a simplification strategy for virologically suppressed people living with HIV-1.
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