Changes in cardiovascular and metabolic risk scores after switching to DOR/3TC/TDF, DTG/3TC or BIC/FTC/TAF: results from a multicenter Italian cohort

Purpose: To assess changes of cardiovascular risk scores
and metabolic scores after switching to DOR/3TC/TDF
(DOR group), DTG/3TC (DTG group) or BIC/FTC/TAF
(BIC group).
Method: We analyzed data from a multicenter cohort of
1069 virologically-suppressed PWH, collecting clinical
history and laboratory parameters at baseline and
48 weeks of follow-up. In eligible PWH we calculated
Body Mass Index (BMI), SCORE-2 and METS-IR at both
timepoints and performed linear mixed model for
repeated measures to measure changes in parameters,
while using linear regression analyses to search for predictors
of change.
Results: Population characteristics are shown in table
below. After 48 weeks, we observed significant changes
in median SCORE-2 in all groups: there were increases of
+0.12 in the DTG group (p=0.021) and +0.30 in the BIC
group (<0.001), while we observed a decrease of -0.35 in
the DOR group (p<0.001). In our regression analyses,
taking DOR/3TC/TDF was a predictor of reduction of
SCORE-2 at week 48 compared with both DTG (B=-
0.80,p<0.001) and BIC (B=-0.81,p<0.001). Moreover, a
higher SCORE-2 at baseline predicted a more pronounced
improvement after 48 weeks in the DOR group
(B=-0.33,p<0.001), while there were no predictors in the
BIC and DTG groups.
Regarding BMI, after 48 weeks we observed a median
increase of +0.2 in BIC (p<0.001), no changes in the
DTG group and a median decrease of -0.04 in the DOR
group (p<0.001). In our regression analyses, taking
DOR/3TC/TDF was a predictor of reduction of BMI at
week 48 compared with both DTG (B=-0.53,p<0.001)
and BIC (B=-0.51,p<0.001).
Finally, regarding METS-IR, after 48 weeks we observed
a significant decrease in the DOR group (-0.9, p=0.024),
while there were no significant changes with DTG and
an increase of +0.3 with BIC (p=0.013).
Conclusions: We found that switching to DOR/3TC/
TDF was associated with more favorable changes in
SCORE-2, METS-IR and BMI compared to DTG/3TC and
BIC/FTC/TAF.