UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Week 96 results of the randomized, multicentre Maraviroc Switch (MARCH) study

Pett, SL; Amin, J; Horban, A; Andrade-Villanueva, J; Losso, M; Porteiro, N; Madero, JS; ... MARCH study group, .; + view all (2018) Week 96 results of the randomized, multicentre Maraviroc Switch (MARCH) study. HIV Medicine , 19 (1) pp. 65-71. 10.1111/hiv.12532. Green open access

[thumbnail of MARCH manuscript for HIV Medicine SHORT REPORT  with abstract included 17Apr2017.pdf]
Preview
Text
MARCH manuscript for HIV Medicine SHORT REPORT with abstract included 17Apr2017.pdf - Accepted Version

Download (127kB) | Preview
[thumbnail of MARCH manuscript for HIV Medicine Figure 1 17Apr2017.pdf]
Preview
Text
MARCH manuscript for HIV Medicine Figure 1 17Apr2017.pdf - Accepted Version

Download (9kB) | Preview
[thumbnail of MARCH manuscript forHIV Medicine Table 1 17Apr2017.pdf]
Preview
Text
MARCH manuscript forHIV Medicine Table 1 17Apr2017.pdf - Accepted Version

Download (10kB) | Preview

Abstract

OBJECTIVES: The Maraviroc Switch (MARCH) study week 48 data demonstrated that maraviroc, a chemokine receptor-5 (CCR5) inhibitor, was a safe and effective switch for the ritonavir-boosted protease inhibitor (PI/r) component of a two nucleos(t)ide reverse transcriptase inhibitor [N(t)RTI] plus PI/r-based antiretroviral regimen in patients with R5-tropic virus. Here we report the durability of this finding. METHODS: MARCH, an international, multicentre, randomized, 96-week open-label switch study, enrolled HIV-1-infected adults with R5-tropic virus who were stable (> 24 weeks) and virologically suppressed [plasma viral load (pVL) < 50 HIV-1 RNA copies/mL]. Participants were randomized to continue their current PI/r-based regimen (PI/r) or to switch to MVC plus two N(t)RTIs (MVC) (1:2 randomization). The primary endpoint was the difference in the proportion with pVL < 200 copies/mL at 96 weeks. The switch arm was defined as noninferior if the lower limit of the 95% confidence interval (CI) for the difference was < -12% in the intention-to-treat (ITT) population. Safety endpoints (the difference in the mean change from baseline or a comparison of proportions) were analysed as key secondary endpoints. RESULTS: Eighty-two (PI/r) and 156 (MVC) participants were randomized and included in the ITT analysis; 71 (87%) and 130 (83%) were in follow-up and on therapy at week 96. At week 96, 89.0% and 90.4% in the PI/r and MVC arms, respectively, had pVL < 50 copies/mL (95% CI -6.6, 10.2). Moreover, in those switching away from PI/r, there were significant reductions in mean total cholesterol (differences 0.31 mmol/L; P = 0.02) and triglycerides (difference 0.44 mmol/L; P < 0.001). Changes in CD4 T-cell count, renal function, and serious and nonserious adverse events were similar in the two arms. CONCLUSIONS: MVC as a switch for a PI/r is safe and effective at maintaining virological suppression while having significant lipid benefits over 96 weeks.

Type: Article
Title: Week 96 results of the randomized, multicentre Maraviroc Switch (MARCH) study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/hiv.12532
Publisher version: http://doi.org/10.1111/hiv.12532
Language: English
Additional information: © 2017 British HIV Association. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV-1, maraviroc, protease inhibitor, switch
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1555741
Downloads since deposit
318Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item