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CCO Management Series

The Role of Integrase Inhibitors in HIV Management

Targeting Integrase: Mechanisms of Action and Mechanisms of Resistance to Integrase Inhibitors

Module 1 of 3

Faculty:

Martin Markowitz, MD
  • Martin Markowitz, MD

CREDIT INFORMATION

Release Date: May 15, 2008

Expiration Date: May 14, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 1.0 Nursing contact hour

Status: The activity is not currently available for credit.

Begin the Module

Martin Markowitz, MD, discusses the role of the integrase enzyme in the HIV replication cycle and the development of resistance to integrase inhibitors.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the role of the integrase enzyme in the HIV replication cycle
  • Discuss the mechanism of action of the current integrase strand transfer inhibitors raltegravir and elvitegravir
  • Summarize the findings regarding the development of resistance in clinical trials of elvitegravir and raltegravir
  • Discuss issues relating to cross-resistance between the integrase inhibitors elvitegravir and raltegravir

Clinical Studies of Integrase Inhibitors: A Comprehensive Review

Module 2 of 3

Faculty:

Martin Markowitz, MD
  • Martin Markowitz, MD

CREDIT INFORMATION

Release Date: April 22, 2008

Expiration Date: April 21, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 1.0 Nursing contact hour

Status: The activity is not currently available for credit.

Begin the Module

Martin Markowitz, MD, discusses recent data from clinical studies involving the use of the integrase inhibitors raltegravir and elvitegravir.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Summarize the results of proof-of-concept clinical trials concerning the use of the integrase inhibitors raltegravir and elvitegravir as monotherapy
  • Describe the results of clinical trials involving the use of raltegravir and elvitegravir in combination therapy regimens in treatment-naive and treatment-experienced patients
  • Discuss the role of additional active agents in the optimized background regimens of raltegravir- and elvitegravir-containing antiretroviral therapy regimens

From Bench to Bedside: The Clinical Role of Integrase Inhibitors

Module 3 of 3

Faculty:

David A. Cooper, MD, DSc
  • David A. Cooper, MD, DSc

CREDIT INFORMATION

Release Date: May 15, 2008

Expiration Date: May 14, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 1.0 Nursing contact hour

Status: The activity is not currently available for credit.

Begin the Module

David A. Cooper, MD, DSc, discusses clinical data on the use of integrase inhibitors for the management of treatment-experienced and treatment-naive HIV-infected patients.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Recount data from clinical studies of the use of the integrase inhibitors raltegravir and elvitegravir
  • Discuss the role of integrase inhibitors in the management of treatment-experienced patients
  • Identify management strategies for antiretroviral-experienced patients who experience virologic failure

Interactive Case Challenges

Management of a Moderately Treatment-Experienced Male Using Novel Antiretroviral Agents

Faculty:

Andrew R. Zolopa, MD
  • Andrew R. Zolopa, MD

CREDIT INFORMATION

Release Date: August 01, 2008

Expiration Date: July 31, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 0.9 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Case Challenge

Andrew R. Zolopa, MD, discusses key issues in the management of a chronically infected patient with persistent viremia.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Discuss the factors to be considered in designing a fully active antiretroviral regimen for a treatment-experienced patient
  • Identify the key interactions between novel antiretroviral agents and other antiretroviral agents
  • Describe the role of tropism testing, including the limitations of tropism testing in developing an antiretroviral regimen

Management of a Virologically Suppressed Patient Experiencing Injection Site Reactions With His Current Regimen

Faculty:

Jonathan M. Schapiro, MD
  • Jonathan M. Schapiro, MD

CREDIT INFORMATION

Release Date: June 12, 2008

Expiration Date: June 11, 2009


Physicians: maximum of 1.0 AMA PRA Category 1 Credit

Registered Nurses: 0.9 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Case Challenge

Jonathan M. Schapiro, MD, discusses management issues in the case of a treatment-experienced male who is experiencing intolerable adverse effects from his successful regimen.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the current indications for recently approved novel antiretroviral agents
  • Discuss key factors to be considered in managing a virologically suppressed patient who is experiencing intolerable adverse events
  • Discuss key factors to be considered in determining viral susceptibility to new agents in switch regimens

Management of a Patient With Extensive Antiretroviral Experience and Persistent Low-Level Viremia

Faculty:

Edwin DeJesus, MD, FACP, AAHIVS
  • Edwin DeJesus, MD, FACP, AAHIVS

CREDIT INFORMATION

Release Date: June 13, 2008

Expiration Date: June 12, 2009


Physicians: maximum of 0.75 AMA PRA Category 1 Credits

Registered Nurses: 0.9 Nursing contact hours

Status: The activity is not currently available for credit.

Begin the Case Challenge

Edwin DeJesus, MD, FACP, discusses issues in managing a clinically stable male patient who has not been able to achieve undetectable HIV-1 RNA

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Identify the current indications for recently approved novel antiretroviral agents
  • Discuss key factors to be considered in managing a treatment-experienced patient who is experiencing persistent low-level viremia
  • Discuss the reasons for including at least 2 new fully active agents when switching a patient to a new antiretroviral regimen

CCO Slideset

The Role of Integrase Inhibitors in HIV Management

Download the Slideset


Martin Markowitz, MD, presents findings on the function of integrase and the role of integrase inhibitors in the management of HIV disease.


Format: Microsoft PowerPoint (.ppt) | File size: 1.41 MB | Date posted: 6/13/2008


Expert Viewpoints


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Resistance to Integrase Inhibitors, Viral Fitness, and Clinical Consequences
Daniel R. Kuritzkes, MD, discusses the clinical implications of findings on integrase-inhibitor resistance presented at the 17th International HIV Drug Resistance Workshop.



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STARTMRK Implications for When to Use Raltegravir
Eric S. Daar, MD, discusses the potential clinical implications of the findings of the STARTMRK trial of raltegravir in antiretroviral-naive patients.



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Update on Recent Clinical Studies of Integrase Inhibitors
Joseph J. Eron, Jr., MD, discusses several studies investigating integrase inhibitors presented at the 2009 Conference on Retroviruses and Opportunistic Infections.

Disclaimer: The materials published on the Clinical Care Options Sites reflect the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the CME provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.

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