Population pharmacokinetic analysis of elvitegravir and cobicistat in HIV-1-infected individuals. Journal of Antimicrobial Chemotherapy
Barceló et al. aimed to develop a population pharmacokinetic model for elvitegravir and cobicistat in a cohort of HIV-1-infected individuals. Concomitant administration of non-ritonavir-boosted atazanavir decreased elvitegravir clearance by 35%. Concomitant administration of non-ritonavir-boosted atazanavir and ritonavir-boosted darunavir decreased cobicistat clearance by 47% and 27%, respectively. A reduced elvitegravir dose of 85 mg co-administered with cobicistat and atazanavir produced a concentration-time course comparable to the standard regimen without atazanavir. None of the demographic and clinical covariates tested appeared to have a significant impact on elvitegravir and cobicistat elimination.
In conclusion, Elvitegravir and cobicistat pharmacokinetic variability appears to be mainly explained by drug-drug interactions that may be encountered in routine clinical practice.