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Efficacy and safety of doravirine in treatment-naive HIV-1-infected adults: a systematic review and meta-analysis

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Abstract

This research aims to study the safety and efficacy of doravirine in the treatment of HIV-1 (human immunodeficiency virus) patients. We conducted an electronic search in eight databases for the inclusion of eligible studies. We have only included randomized controlled trials (RCTs) that study the safety and efficacy of doravirine in the treatment of HIV-1 adult patients. Six papers were included in this meta-analysis. For network (direct and indirect) estimates, the doravirine 100 mg treatment strategy found to have the highest efficacy (P score = 0.786) followed by doravirine 25 mg (P score = 0.684), efavirenz 600 mg (P score = 0.574), doravirine 200 mg (P score = 0.532), 100 mg ritonavir and plus 800 mg darunavir (P score = 0.416), and placebo (P score = 0.009), respectively. Regarding drug-related AE, the placebo group found to have the highest safety profile with the least AE rates (P score = 0.927) followed by doravirine 100 mg (P score = 0.720), 100 mg ritonavir and plus 800 mg darunavir (P score = 0.717), doravirine 25 mg (P score = 0.336), doravirine 200 mg (P score = 0.258), and efavirenz 600 mg (P score = 0.043), respectively. Nevertheless, there was no significant difference between DOR 100 mg in comparison with 100 mg ritonavir and plus 800 mg darunavir (OR = 1.14; 95% CI = 0.23–5.74), DOR 25 mg (OR = 0.37; 95% CI = 0.06–2.34), DOR 200 mg (OR = 0.89; 95% CI = 0.17–4.59), or efavirenz 600 mg (OR = 0.58; 95% CI = 0.17–1.98). Moreover, the pairwise (direct only) comparisons did not show a significant difference between doravirine (all doses) and other treatment groups. Doravirine could be counted as an efficacious, safe, and well-tolerated treatment option that is preferable to other regimens for the initial therapy of individuals with HIV-1 infection.

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All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Acknowledgement

This research was funded by the Deanship of Scientific Research at Princess Nourah Bint Abdulrahman University through the Fast-track Research Funding Program.

Author information

Authors and Affiliations

  1. Potion CRO Company, Al Malqa, Riyadh, Saudi Arabia

    Marwa Adel Afify

  2. Ministry of Health and Population, Cairo, Egypt

    Iman Gamal Ghareeb Ahmed

  3. NAMA LLC, Al Malqa, Riyadh, Saudi Arabia

    Theeb Ayedh Alkahtani

  4. Microbiology Unit, Department of Pathology, King Saud University, Riyadh, Saudi Arabia

    Raed Ibrahim Altulayhi

  5. King Salman Armed Forces Hospital, NorthWest Tabuk, Saudi Arabia

    Amjad Saud Mhrb Alrowili

  6. Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Sherief Ghozy

  7. Biology Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

    May Bin-Jumah

  8. Department of Zoology, Science College, King Saud University, Riyadh, 11451, Saudi Arabia

    Mohamed M. Abdel-Daim

  9. Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt

    Mohamed M. Abdel-Daim

Authors
  1. Marwa Adel Afify
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  2. Iman Gamal Ghareeb Ahmed
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  8. Mohamed M. Abdel-Daim
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Contributions

Conceptualization: Marwa Adel Afify and Sherief Ghozy; methodology: Marwa Adel Afify, Iman Gamal Ghareeb Ahmed; Validation: Marwa Adel Afify, and Iman Gamal Ghareeb Ahmed; data curation: Theeb Ayedh Alkahtani and Raed Ibrahim Altulayhi; formal analysis: Sherief Ghozy; writing—original draft: Marwa Adel Afify and Iman Gamal Ghareeb Ahmed; writing—review and editing: Theeb Ayedh Alkahtani, Raed Ibrahim Altulayhi, Amjad Saud Mhrb Alrowili, and Mohamed M. Abdel-Daim; visualization: Raed Ibrahim Altulayhi and Amjad Saud Mhrb Alrowili; supervision: Sherief Ghozy, May Bin-Jumah, and Mohamed M. Abdel-Daim; project administration: Theeb Ayedh Alkahtani, Amjad Saud Mhrb Alrowili, May Bin-Jumah, and Mohamed M. Abdel-Daim; funding acquisition: May Bin-Jumah.

Corresponding authors

Correspondence to Sherief Ghozy or Mohamed M. Abdel-Daim.

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Highlights

• Doravirine (DOR) 100 mg regimen has favorable efficacy and safety profiles.

• DOR 100 mg regimen found to have the highest efficacy followed by DOR 25 mg.

• DOR 100 mg regimen came in the second place in terms of overall adverse events.

• DOR 100 mg regimen was the safest in terms of drug-related adverse events.

Electronic supplementary material

ESM 1

Comparison adjusted funnel plot to assess the risk of bias for overall adverse events. (PNG 6369 kb)

High resolution image (TIF 302 kb)

ESM 2

Netheat plot to assess heterogeneity. The colors are associated with the change in inconsistency between direct and indirect evidence. Blue colors indicate an increase and warm colors indicate a decrease (the stronger the intensity of the color, the stronger the change). (PNG 6369 kb)

High resolution image (TIF 201 kb)

ESM 3

Comparison adjusted funnel plot to assess the risk of bias for drug-related adverse events. (PNG 6369 kb)

High resolution image (TIF 303 kb)

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Afify, M.A., Ahmed, I.G.G., Alkahtani, T.A. et al. Efficacy and safety of doravirine in treatment-naive HIV-1-infected adults: a systematic review and meta-analysis. Environ Sci Pollut Res 28, 10576–10588 (2021). https://doi.org/10.1007/s11356-020-11267-0

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  • DOI: https://doi.org/10.1007/s11356-020-11267-0

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