572-Trii
dolutegravir / abacavir / lamivudine, or DTG / ABC / 3TC
STR: Single-tablet regimen | INSTI and NRTIs
image of drug

MANUFACTURER:
ViiV Healthcare viivhealthcare.com
(877) 844-8872

AWP:
TBD; investigational drug at press time

Standard Dose:

One tablet (50 mg dolutegravir / 600 mg abacavir / 300 mg lamivudine) once a day for people on HIV therapy for the first time used in research. Twice-daily dosing in people who have viral resistance to Isentress and elvitegravir.

Take missed dose as soon as possible, unless it is closer to the time of your next dose. Do not double up on your next dose.

Potential side effects and toxicity

See the individual drugs contained in 572-Trii: Tivicay, Ziagen, and Epivir. Available data are limited due to investigational drug status.

Check for potential drug class side effects.

Potential drug interactions

See the individual drugs contained in 572-Trii: Tivicay, Ziagen, and Epivir. Tell your provider or pharmacist about all medications, herbs, and supplements you are taking or thinking of taking, prescribed or not. Do not take with Tikosym (a heart medicine). Do not take 572-Trii with Atripla, Complera, Emtriva, Epivir, Epzicom, Tivicay, Truvada, Viread, or Ziagen, since these medications are already in 572-Trii or they have equivalent medications. Reyataz and Prezista change Tivicay levels, but no dose adjustment is needed. Intelence decreases Tivicay levels by 88%, so your HIV provider would also need to prescribe Kaletra, ritonavir-boosted Prezista, or ritonavir-boosted Reyataz. 572-Trii should be taken two hours before or six hours after taking antacids (like Maalox), the ulcer medication Carafate, iron or calcium supplements or buffered medications. These medications reduce the absorption of Tivicay. Non-antacid acid reflux/heartburn medications (like omeprazole) are okay to use. Avoid taking with some seizure medicines (carbamazepine, oxcarbazepine, phenobarbital, and phenytoin) and St. John’s wort. Metformin dose may need to be adjusted. Rifampin should be avoided by people with suspected INSTI resistance. 572-Trii has no effect on Versed, methadone, or oral contraceptives. More drug interactions are anticipated, but data are limited right now due to investigational drug status.

More information

ViiV Healthcare applied late last year for FDA approval of this single-tablet regimen containing dolutegravir, abacavir, and lamivudine. See the individual drugs contained in 572-Trii—Tivicay, Ziagen, and Epivir as well as Epzicom (Ziagen/Epivir)—for more information. Based on the current data, 572-Trii appears to be an exciting addition to the current antiretrovirals. It gives us another single-tablet complete regimen. There will be twice-daily dosing for patients with INSTI drug resistance. It should have fewer drug interactions than Stribild and appears to be well tolerated. The SINGLE study showed that 572-Trii was superior to Atripla in patients who are treatment-naïve (meaning that they have never been on HIV medications before). At 48 weeks, 88% of study participants on the dolutegravir regimen were virologically suppressed (less than 50 copies/mL) vs. 81% of participants on Atripla. Differences in the slightly better outcomes for Tivicay were mostly driven by a higher rate of discontinuation due to side effects in the Atripla group. Check for hepatitis B before starting therapy (see Epivir). 572-Trii is pronounced “572-try.” See package insert, when available, for more complete information on potential side effects and interactions.

Doctor’s comments

A single-tablet pill combining dolutegravir, abacavir and lamivudine is expected soon. Its simplicity and effectiveness could lead to a renewed enthusiasm for abacavir, especially since its lower efficacy at high viral loads wasn’t an issue when it was combined with dolutegravir. The lingering heart attack controversy with abacavir is still an issue though (see Ziagen).
—JOEL GALLANT, MD, MPH

Activist’s comments

Yet another fixed dose combination regimen. There is no doubt that, for some patients, having all the meds in one pill is awesome. However, the reality of sorting out toxicities and helping folks to see that even if they struggle with the “easy” approach of a single-tablet regimen, that doesn’t mean they can’t succeed by constructing a regimen the good old fashioned way continues to concern me. The ability to avoid a booster may appeal to some, but overall, it’s difficult to imagine how this particular regimen would surface at the top of a first regimen list.
—DAWN AVERITT


top