Utilidad clínica de atazanavir
Clinical utility of atazanavir
Esteban Ribera Pascuet
, Adrià Curran
Autor para correspondencia
eribera@vhebron.net
Correspondencia: Dr. E. Ribera Pascuet. Servicio de Enfermedades Infecciosas. Sexta planta. Hospital Universitario Vall d’Hebron. Paseo Vall d’Hebron, 119-129. 08035 Barcelona. España.
Correspondencia: Dr. E. Ribera Pascuet. Servicio de Enfermedades Infecciosas. Sexta planta. Hospital Universitario Vall d’Hebron. Paseo Vall d’Hebron, 119-129. 08035 Barcelona. España.
Servicio de Enfermedades Infecciosas. Hospital Universitari Vall d’Hebron. Barcelona. España
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"documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2008;26 Supl 17:49-54" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1265 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 805 "PDF" => 452 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Utilidad de atazanavir en poblaciones especiales" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "49" "paginaFinal" => "54" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Utility of atazanavir in special populations" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Antela López" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Antonio Antela" "apellidos" => "López" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X08766217?idApp=UINPBA00004N" "url" => "/0213005X/0000002600000S17/v1_201305090109/S0213005X08766217/v1_201305090109/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Utilidad clínica de atazanavir" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "67" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Esteban Ribera Pascuet, Adrià Curran" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Esteban Ribera" "apellidos" => "Pascuet" "email" => array:1 [ 0 => "eribera@vhebron.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Adrià" "apellidos" => "Curran" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Enfermedades Infecciosas. Hospital Universitari Vall d’Hebron. Barcelona. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. E. Ribera Pascuet. Servicio de Enfermedades Infecciosas. Sexta planta. Hospital Universitario Vall d’Hebron. Paseo Vall d’Hebron, 119-129. 08035 Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical utility of atazanavir" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec137572" "palabras" => array:6 [ 0 => "Atazanavir" 1 => "Inhibidores de la proteasa" 2 => "Infección por el VIH" 3 => "Tratamiento inicial" 4 => "Simplificación de tratamiento" 5 => "Tratamiento de rescate" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec137573" "palabras" => array:6 [ 0 => "Atazanavir" 1 => "Protease inhibitors" 2 => "HIV infection" 3 => "Initial treatment" 4 => "Simplification treatment" 5 => "Rescue treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Atazanavir (ATV) es un inhibidor de la proteasa (IP) cuyas principales cualidades en comparación con los otros IP son la cómoda dosificación, la buena tolerabilidad y el excelente perfil metabólico. Estas características hacen que se asemeje más a un no nucleósido que a un IP, pero con la elevada barrera genética propia de los IP. Está indicado en el tratamiento inicial, en la simplificación del tratamiento o el cambio por toxicidad, y en las primeras líneas de rescate. En Europa se ha aprobado la administración de ATV potenciado con ritonavir (300/100 mg/día) en todos los escenarios clínicos. En pacientes naïve se ha combinado con prácticamente todas la parejas de análogos de los nucleósidos y ha demostrado ser tan eficaz como lopinavir/ritonavir e incluso como efavirenz. En Estados Unidos, esta indicación está aprobada desde hace casi 5 años y ATV se ha convertido en el IP más prescrito, mientras que la Asociación Europea del Medicamento (EMEA) la ha aprobado este año. ATV es un fármaco óptimo para sustituir a otros antirretrovirales en estrategias de simplificación o cambios por toxicidad. En varios estudios se ha demostrado que en pacientes con buen control virológico puede sustituir a lopinavir/r o a otro IP, manteniéndose la eficacia terapéutica, con una excelente tolerabilidad y una mejoría del perfil lipídico, y con una disminución del riesgo cardiovascular. Esta estrategia es ampliamente utilizada en España. En este escenario, algunos pacientes podrían beneficiarse del tratamiento con ATV no potenciado (400 mg/día). ATV es una opción eficaz y muy atractiva en las primeras líneas de rescate en que el virus muestra escasa o nula resistencia a los IP, pues su simplicidad y tolerabilidad pueden mejorar los problemas de adhesión, principal causa de los fracasos terapéuticos. En pacientes con resistencia moderada a los IP, ATV es tan eficaz como LPV/r. La supervivencia de los pacientes con infección por el virus de la inmunodeficiencia humana (VIH) es cada vez más prolongada y cobran mayor importancia factores como la tolerabilidad, el riesgo cardiovascular y la adaptabilidad del tratamiento a la vida del paciente, por lo cual ATV debe desempeñar un importante papel en el tratamiento de la infección por el VIH.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Atazanavir (ATV) is a protease inhibitor (PI) in which its main qualities, compared to other PI are dosing convenience, good tolerability and excellent metabolic profile. These characteristics makes it more like a nonnucleoside than a PI, but with the increased genetic barrier common to PI. It is indicated in initial treatment, simplification treatment or a change due to toxicity and in first line rescue treatment. The administering of ATV boosted with ritonavir (300/100 mg/d) has been approved in Europe in all clinical situations. In naïve patients it has been combined with practically all the nucleoside analogue pairs and has shown to be as effective as lopinavir/ritonavir and even efavirenz. In the USA, this indication has been approved for almost 5 years and ATV has become the most prescribed PI, while the EMEA has approved it this year. ATV is an optimal drug to replace other antiretrovirals in simplification strategies or changes due to toxicity. In several studies it has been shown that, in patients with good virological control, it can LPV/r or another PI, the therapeutic efficacy being maintained, with excellent tolerance and an improved lipid profile, and decreasing the cardiovascular risk. This strategy is widely used in Spain. In this scenario some patients could benefit from non-boosted ATV treatment (400 mg/d). ATV is an effective and very attractive option in first line rescue treatments in which the virus shows little or no resistance to PI, as its simplicity and tolerability can improve problems with compliance, the main cause of therapeutic failure. In patients with moderate resistance to PI, ATV is as effective as LPV/r. The survival of patients with HIV infection is increasingly longer and factors such as tolerability, cardiovascular risk and the adaptability of the treatment to the lifestyle of the patient, become more important, therefore ATV must play an important role in the treatment of HIV-infection.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:72 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Antela" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enf Infec Microbiol Clin" "fecha" => "2008" "volumen" => "26" "numero" => "Supl 17" "paginaInicial" => "49" "paginaFinal" => "54" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/0213005X/0000002600000S17/v1_201305090109/S0213005X08766229/v1_201305090109/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000002600000S17/v1_201305090109/S0213005X08766229/v1_201305090109/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X08766229?idApp=UINPBA00004N" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 17 | 5 | 22 |
| 2024 Septiembre | 18 | 4 | 22 |
| 2024 Agosto | 15 | 3 | 18 |
| 2024 Julio | 10 | 4 | 14 |
| 2024 Junio | 20 | 5 | 25 |
| 2024 Mayo | 15 | 1 | 16 |
| 2024 Abril | 10 | 1 | 11 |
| 2024 Marzo | 21 | 8 | 29 |
| 2024 Febrero | 21 | 3 | 24 |
| 2024 Enero | 29 | 8 | 37 |
| 2023 Diciembre | 26 | 4 | 30 |
| 2023 Noviembre | 32 | 5 | 37 |
| 2023 Octubre | 10 | 4 | 14 |
| 2023 Septiembre | 8 | 0 | 8 |
| 2023 Agosto | 9 | 0 | 9 |
| 2023 Julio | 7 | 5 | 12 |
| 2023 Junio | 6 | 5 | 11 |
| 2023 Mayo | 10 | 4 | 14 |
| 2023 Abril | 10 | 1 | 11 |
| 2023 Marzo | 9 | 1 | 10 |
| 2023 Febrero | 3 | 7 | 10 |
| 2023 Enero | 19 | 3 | 22 |
| 2022 Diciembre | 8 | 10 | 18 |
| 2022 Noviembre | 21 | 15 | 36 |
| 2022 Octubre | 17 | 4 | 21 |
| 2022 Septiembre | 19 | 14 | 33 |
| 2022 Agosto | 8 | 17 | 25 |
| 2022 Julio | 16 | 7 | 23 |
| 2022 Junio | 10 | 9 | 19 |
| 2022 Mayo | 10 | 6 | 16 |
| 2022 Abril | 14 | 6 | 20 |
| 2022 Marzo | 16 | 7 | 23 |
| 2022 Febrero | 6 | 6 | 12 |
| 2022 Enero | 36 | 6 | 42 |
| 2021 Diciembre | 32 | 10 | 42 |
| 2021 Noviembre | 14 | 5 | 19 |
| 2021 Octubre | 12 | 8 | 20 |
| 2021 Septiembre | 13 | 19 | 32 |
| 2021 Agosto | 8 | 7 | 15 |
| 2021 Julio | 4 | 7 | 11 |
| 2021 Junio | 10 | 6 | 16 |
| 2021 Mayo | 6 | 9 | 15 |
| 2021 Abril | 31 | 13 | 44 |
| 2021 Marzo | 23 | 11 | 34 |
| 2021 Febrero | 5 | 3 | 8 |
| 2021 Enero | 5 | 7 | 12 |
| 2020 Diciembre | 2 | 6 | 8 |
| 2020 Noviembre | 6 | 6 | 12 |
| 2020 Octubre | 3 | 5 | 8 |
| 2020 Septiembre | 8 | 8 | 16 |
| 2020 Agosto | 11 | 7 | 18 |
| 2020 Julio | 7 | 7 | 14 |
| 2020 Junio | 4 | 2 | 6 |
| 2020 Mayo | 8 | 4 | 12 |
| 2020 Abril | 17 | 0 | 17 |
| 2020 Marzo | 5 | 3 | 8 |
| 2020 Febrero | 5 | 6 | 11 |
| 2020 Enero | 1 | 9 | 10 |
| 2019 Diciembre | 11 | 9 | 20 |
| 2019 Noviembre | 4 | 4 | 8 |
| 2019 Octubre | 3 | 5 | 8 |
| 2019 Septiembre | 7 | 5 | 12 |
| 2019 Agosto | 1 | 6 | 7 |
| 2019 Julio | 7 | 12 | 19 |
| 2019 Junio | 22 | 34 | 56 |
| 2019 Mayo | 93 | 71 | 164 |
| 2019 Abril | 31 | 42 | 73 |
| 2019 Marzo | 4 | 10 | 14 |
| 2019 Febrero | 5 | 18 | 23 |
| 2019 Enero | 5 | 4 | 9 |
| 2018 Diciembre | 4 | 10 | 14 |
| 2018 Noviembre | 3 | 3 | 6 |
| 2018 Octubre | 6 | 4 | 10 |
| 2018 Septiembre | 4 | 1 | 5 |
| 2018 Agosto | 4 | 8 | 12 |
| 2018 Julio | 2 | 5 | 7 |
| 2018 Junio | 1 | 10 | 11 |
| 2018 Mayo | 3 | 12 | 15 |
| 2018 Abril | 1 | 8 | 9 |
| 2018 Marzo | 0 | 3 | 3 |
| 2018 Febrero | 1 | 1 | 2 |
| 2018 Enero | 0 | 1 | 1 |
| 2017 Diciembre | 2 | 2 | 4 |
| 2017 Noviembre | 2 | 1 | 3 |
| 2017 Octubre | 0 | 3 | 3 |
| 2017 Septiembre | 4 | 6 | 10 |
| 2017 Agosto | 5 | 1 | 6 |
| 2017 Julio | 1 | 5 | 6 |
| 2017 Junio | 8 | 9 | 17 |
| 2017 Mayo | 14 | 2 | 16 |
| 2017 Abril | 10 | 4 | 14 |
| 2017 Marzo | 7 | 26 | 33 |
| 2017 Febrero | 4 | 3 | 7 |
| 2017 Enero | 7 | 0 | 7 |
| 2016 Diciembre | 8 | 2 | 10 |
| 2016 Noviembre | 5 | 1 | 6 |
| 2016 Octubre | 12 | 4 | 16 |
| 2016 Septiembre | 13 | 3 | 16 |
| 2016 Agosto | 12 | 1 | 13 |
| 2016 Julio | 3 | 1 | 4 |
| 2016 Junio | 13 | 10 | 23 |
| 2016 Mayo | 9 | 18 | 27 |
| 2016 Abril | 3 | 12 | 15 |
| 2016 Marzo | 5 | 15 | 20 |
| 2016 Febrero | 4 | 8 | 12 |
| 2016 Enero | 9 | 11 | 20 |
| 2015 Diciembre | 3 | 13 | 16 |
| 2015 Noviembre | 8 | 8 | 16 |
| 2015 Octubre | 2 | 10 | 12 |
| 2015 Septiembre | 7 | 4 | 11 |
| 2015 Agosto | 10 | 4 | 14 |
| 2015 Julio | 4 | 2 | 6 |
| 2015 Junio | 1 | 1 | 2 |
| 2015 Mayo | 4 | 2 | 6 |
| 2015 Abril | 6 | 7 | 13 |
| 2015 Marzo | 5 | 5 | 10 |
| 2015 Febrero | 4 | 4 | 8 |
| 2015 Enero | 8 | 2 | 10 |
| 2014 Diciembre | 13 | 5 | 18 |
| 2014 Noviembre | 8 | 3 | 11 |
| 2014 Octubre | 18 | 2 | 20 |
| 2014 Septiembre | 16 | 0 | 16 |
| 2014 Agosto | 8 | 0 | 8 |
| 2014 Julio | 10 | 1 | 11 |
| 2014 Junio | 16 | 0 | 16 |
| 2014 Mayo | 9 | 0 | 9 |
| 2014 Abril | 11 | 2 | 13 |
| 2014 Marzo | 14 | 0 | 14 |
| 2014 Febrero | 10 | 2 | 12 |
| 2014 Enero | 12 | 0 | 12 |
| 2013 Diciembre | 13 | 3 | 16 |
| 2013 Noviembre | 11 | 3 | 14 |
| 2013 Octubre | 18 | 5 | 23 |
| 2013 Septiembre | 6 | 7 | 13 |
| 2013 Agosto | 16 | 4 | 20 |
| 2013 Julio | 10 | 2 | 12 |
| 2008 Diciembre | 291 | 0 | 291 |
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