Triumeq a new single tablet regimen (STR), combining abacavir 600mg, dolutegravir 50mg and lamivudine 300 mg has been approved by the Therapeutic Goods Administration (TGA) in Australia. It is manufactured by ViiV Healthcare and is already available in the US (Aug 2014) and European Union (Sept 2014).
It is the first single-tablet regime that does not contain Truvada (tenofovir disoproxil fumerate/emtricitabine), making it a potential option for those who have impaired kidney function and/or bone toxicity.
Triumeq is considered suitable for ARV treatment-naïve or those without resistance to any of the three ARV agents (abacavir, dolutegravir, lamivudine). A component of Triumeq – dolutegravir, is a second generation intergrase inhibitor and is suitable for those who have resistance to first gen raltegravir and elvitegravir.
Before commencing Triumeq an abacavir hypersensitivity test is conducted, this genetic test screens for the presence of the human leukocyte antigen HLA-B*5701 allele. Presence of the HLA-B85701 allele is strongly associated with a hypersensitivity reaction to abacavir. Without genetic screening the reaction occurs in 5-8% of patients and is most common in those with a Northern European descent. Hypersensitivity to abacavir is a multi-organ syndrome, including symptoms such as rash, fever, fatigue, nausea, diarrhoea, abdominal pain and respiratory issues. Symptoms typically appear in the first 6 weeks of commencing abacavir treatment.
Triumeq can be taken with or without food and there are no restrictions regarding level of viral load or CD4 count.
Triumeq is not yet available on the Pharmaceutical Benefits Scheme (PBS). A decision is expected in Q2 2015.