Abstract
Etravirine is metabolized by three cytochrome P450 enzymes that are in turn induced by rifampin. Consequently, co-administration of etravirine and rifampin is not recommended. To date, however, no clinical studies exploring the drug–drug interaction of this combination have been conducted. Here we report two cases of off-label etravirine use concurrently with antitubercular treatment, dictated by the unavailability of other treatments. Plasma drug concentrations were monitored by regular measurements. Our results appear to confirm the increased metabolism of etravirine through the induction of cytochrome P450 enzymes, but the adequacy of drug levels in all of the measurements and subsequent virological suppression suggest that this drug interaction may not be clinically relevant.
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Conflict of interest
MF received speakers’ honoraria from Merck Sharp & Dohme and Janssen-Cilag. PN received speakers’ honoraria from Boehringer Ingelheim, GlaxoSmithKline, Gilead and Janssen-Cilag. RC had been advisor for Gilead and Janssen-Cilag, received speakers’ honoraria from ViiV, Bristol-Myers Squibb, Merck Sharp and Dohme and Janssen-Cilag, and research support from “Fondazione Roma”. MC has been a paid consultant for Merck Sharp & Dohme, Italy and was employed by Bristol-Myers-Squibb, Italy since May 10, 2010 to Feb 28 2011. ADL received speaker’s honoraria and fees for attending advisory boards from ViiV Healthcare, Gilead, Abbott Virology, Janssen-Tibotec, Siemens Diagnostics and Monogram Biosciences. SDG received speakers’ honoraria and support for travel meetings from Gilead, Bristol-Myers Squibb, Abbott, Boehringer Ingelheim, Janssen-Cilag, and GlaxoSmithKline. The other authors have nothing to declare.
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Gagliardini, R., Fabbiani, M., Fortuna, S. et al. Pharmacokinetics of etravirine in HIV-infected patients concomitantly treated with rifampin for tuberculosis. Infection 42, 775–778 (2014). https://doi.org/10.1007/s15010-014-0599-z
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DOI: https://doi.org/10.1007/s15010-014-0599-z