Profile of etravirine for the treatment of HIV infection

Alice Tseng, Rodger D. MacArthur

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

Etravirine is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with the advantages of in vitro potency against many strains of virus resistant to efavirenz and nevirapine, as well as a higher genetic barrier to resistance. Etravirine is indicated for use in treatment-experienced patients, and the approved dose in adults is 200 mg twice daily. Etravirine should be administered after a meal as bioavailability is significantly reduced when taken in the fasting state. Etravirine is a substrate of CYP3A4, CYP2C9, CYP2C19, and uridine diphosphate glucuronyltransferase, and induces CYP3A4, weakly inhibits CYP2C9 and moderately inhibits CYP2C19. Etravirine may be coadministered with nucleoside/tide reverse transcriptase inhibitors, raltegravir and boosted darunavir, lopinavir, and saquinavir without dosage adjustment. Etravirine should not be given with other NNRTIs, unboosted protease inhibitors, and atazanavir/ritonavir, tipranavir/ritonavir, and fosamprenavir/ritonavir due to unfavorable drug interactions. In randomized, controlled trials, twice daily etravirine combined with darunavir/ritonavir plus optimized background therapy demonstrated better efficacy compared to darunavir/ritonavir plus optimized background therapy alone in treatment-experienced populations out to 96 weeks follow-up. The main etravirine-associated toxicity is mild to moderate self-limiting rash, although severe and sometimes fatal hypersensitivity reactions have been reported. Etravirine offers a potent sequencing option after the development of resistance to first-line NNRTIs, and is a welcome addition to this established drug class.

Original languageEnglish (US)
Pages (from-to)49-58
Number of pages10
JournalTherapeutics and Clinical Risk Management
Volume6
Issue number1
StatePublished - Apr 19 2010
Externally publishedYes

Keywords

  • Efficacy
  • Etravirine
  • Pharmacology
  • Resistance
  • Review

ASJC Scopus subject areas

  • Safety Research
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)
  • Chemical Health and Safety

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