European Journal of Clinical Pharmacology

, Volume 75, Issue 5, pp 733–735 | Cite as

Different effects of glucocorticoids on darunavir plasma concentrations

  • Dario CattaneoEmail author
  • Stefania Cheli
  • Marta Fusi
  • Emilio Clementi
  • Cristina Gervasoni
Letter to the Editor

In vitro studies have shown that glucocorticoids significantly modulate the activity of metabolic enzymes [1, 2, 3]. However, clinical studies aimed at assessing the impact of glucocorticoids on drug bioavailability have provided conflicting results [4]. Here, we describe two HIV-infected patients in whom glucocorticoids had opposite effects on darunavir plasma concentrations.

The first case was an HIV-infected 57-year-old man who had been on maintenance antiretroviral treatment since 2000. The current regimen consisted of darunavir/cobicistat 800/150 mg and tenofovir alafenamide/emtricitabine 10/200 mg, with optimal immune-virological outcome (CD4 cell count: 828 cells/mm3; HIV-RNA <37 copies/mL). Darunavir plasma trough concentrations, measured by high-performance liquid chromatography during outpatient visits at the Ambulatory Polytherapy Management (Gestione Ambulatoriale Politerapie: GAP), were always above the minimum effective drug concentrations set at 550 ng/mL [5], with mean...


Authors contribution

DC and CG supervised all the stages of the study and wrote the first draft of the manuscript. MF and SC performed pharmacokinetic and pharmacogenetic analyses and revised the draft manuscript. EC critically revised the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest. The work was not funded or supported.

Informed consent of the patients

Both patients provided signed informed consent for pharmacogenetic analyses.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Gestione Ambulatoriale Politerapie (GAP) outpatient clinicASST Fatebenefratelli Sacco University HospitalMilanItaly
  2. 2.Unit of Clinical PharmacologyASST Fatebenefratelli Sacco University HospitalMilanItaly
  3. 3.Clinical Pharmacology Unit, Consiglio Nazionale delle Ricerche Institute of Neuroscience, Department of Biomedical and Clinical SciencesSacco University Hospital, Università degli Studi di MilanoMilanItaly
  4. 4.E. Medea Scientific InstituteBosisio PariniItaly
  5. 5.Department of Infectious DiseasesASST Fatebenefratelli Sacco University HospitalMilanItaly

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