Atazanavir en el tratamiento de simplificación

Zamora, Laura; Gatell, José María

doi:10.1016/S0213-005X(08)76615-1

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Atazanavir es un nuevo inhibidor de la proteasa azapéptido con un perfil farmacocinético singular, que permite la administración una vez al día de sólo 2 cápsulas en combinación con otros antirretrovirales. Su potente eficacia antiviral se acompaña, además, de un perfil de tolerancia excelente y de ausencia de incrementos significativos de las concentraciones de colesterol y triglicéridos. La respuesta inmunológica y virológica obtenida con atazanavir o atazanavir/ritonavir, tanto en pacientes naive como en pacientes con fracaso virológico previo a otros inhibidores de la proteasa, es excelente. Atazanavir es un atractivo fármaco para la simplificación terapéutica. Además de mantener la supresión virológica, los pacientes que cambian de otros inhibidores de la proteasa a atazanavir presentan reducciones en el colesterol total, el colesterol unido a lipoproteínas de alta densidad (cHDL) y los triglicéridos. Datos preliminares indican también que el tratamiento de mantenimiento simplificado con atazanavir/ritonavir en monoterapia puede mantener la supresión virológica de manera eficaz en pacientes seleccionados.

Palabras clave:

Atazanavir

Inhibidores de la proteasa

Simplificación

Tratamiento de mantenimiento

Tratamiento de rescate

Atazanavir is a new azapeptide protease inhibitor with a remarkable pharmacokinetic profile, which means it can be administered in only two capsules once per day in combination with other antiretrovirals. Its strong antiviral efficacy is also accompanied by an excellent tolerance profile and no significant increase in cholesterol and triglyceride levels. The immunological and virological response obtained with atazanavir or atazanavir/ritonavir, in naive patients as well as in patients with previous virological failure with other protease inhibitors, is excellent. Atazanavir is an attractive drug for therapeutic simplification. Besides maintaining virological suppression, patients who change from other PI to atazanavir experience reductions in total cholesterol, HDL cholesterol and triglycerides. Preliminary data suggest that simplified maintenance treatment with atazanavir/ritonavir in monotherapy, can effectively maintain virological suppression in selected patients.

Key words:

Atazanavir (ATV)

Protease inhibitor (PI)

Simplification

Maintenance treatment

Rescue treatment

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