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Author Topic: Switching from Biktarvy to Dovato  (Read 2041 times)

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Offline TexasDragon

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  • Posts: 114
Switching from Biktarvy to Dovato
« on: March 16, 2021, 07:43:13 pm »
Just had my regular follow-up with my ID Doc. She wants to switch me from Biktarvy to Dovato.

I have had zero issue with Biktarvy, got to undetectable within a month or two of starting, and have maintained a CD4 over 1k for more than two years now.

She just feels a two-drug combo is better than a three-drug combo in the long run. Both are well tolerated and she doesnít think I will have any issues. The cost to me will be the same - essentially zero after my co-pay card from the maker.

Any thoughts?
Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20
09-29-2020 Blood Draw - CD4 972 32% VL <20
03-25-2021 Blood Draw - CD4 1168 38% VL = 26

Offline Matths

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  • Posts: 53
Re: Switching from Biktarvy to Dovato
« Reply #1 on: March 17, 2021, 08:05:59 am »
Hi there, my thinking is to never change a winning team. For me personally, I have been a winning team with Dovato for almost 2 years now. Have been UD, no side effects, and I agreed with my doctor that in the long run achieving UD and other parameters with 2 meds instead of 3 may be beneficial. I also have 100% compliance so the opinion that is raised occasionally that a 3-med combo may be superior to a 2-med combo in people who occasionally miss a dose doesnít apply to me. At the end, I believe itís a decision between you and your doc. Most important seems to me that you are comfortable with your treatment and can trust that your medicine works for you. Best Matt

Offline leatherman

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Re: Switching from Biktarvy to Dovato
« Reply #2 on: March 17, 2021, 08:11:08 pm »
my thinking is to never change a winning team
i certainly agree if it ain't broke, don't fix it

However, Texas, if you want to consider "fixing" your regimen, then you might want to ponder the options. Is it fewer pills (lower the pill burden)? Is it more effective (ie fights HIV more effectively and/or fewer side effects)? Is it less restrictive (no multiple doses, no food requirements)? Does it reduce your healthcare costs?

All those are possibly good reasons to change. But if a regime change doesn't affect any of those issues (or not by enough), then it's not broke and doesn't need fixed.  ;) ;)

She just feels a two-drug combo is better than a three-drug combo in the long run.
did she explain her feeling? if so, what did you think about that explanation? How much do you trust the skills of your doctor? **

I found this information https://www.catie.ca/en/treatmentupdate/treatmentupdate-233/anti-hiv-agents/switching-dovato-dolutegravir-3tc-taf-based-regi you might be interested in. After reading it, I believe the suggestion might be to "not fix it"




**(it's always prudent to be honest about the skills your doctor has. You can really "like" your doctor and you can think you're getting good health care; but it pays to consider just how healthy you keep yourself with their opinions and care. In my 28 yrs of HIV health care, I've had several HIV docs and have always stayed well researched on treatments myself. While most of those doctors have really worked well with me and have been on top of their game with HIV/treatment information, I've had two who were simply not good for me. While both did the basics of healthcare, they just weren't as well versed as I am as a layman, and without that trust in my doctor's HIV knowledge, I quit being their patient and found another doctor.)[/size]
leatherman (aka mIkIE)

Offline Texland

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  • Posts: 40
Re: Switching from Biktarvy to Dovato
« Reply #3 on: March 26, 2021, 12:59:42 am »
I was going to make a separate post about this, but you already asked about this switch.

--Short version--
I'd say switching to Dovato may be good, if you haven't been on any of the component medicines before.


--Long version--
I was on Biktarvy since it was in clinical trials. After a couple months on it I suddenly gained 25 pounds. Docs insisted it wasn't the Biktarvy causing the weight gain. Over the years since then, I've only lost about five pounds. Numbers were good, stayed at UD most of the time, I did throw a couple tests with a viral load of 20 or 50. During the trial there were twice a month blood draws at times.

Fast forward to last year. Talking with the doctor about Biktarvy, he said they had discovered that it caused weight gain. He said I could switch to Dovato. I went on Dovato last April. Everything was great. I never noticed a thing when I switched meds. First blood test came back undetectable. Around the end of August I had another set of labs drawn. That one came back with a viral load of 57. Doc said don't worry about it.

All this time I've been looking for a new doctor. One was recommended over a year ago. She wasn't taking new patients because of Covid. Last month I finally was accepted as her patient. Right off the bat she was concerned that I was on Dovato, because I first tested positive in 1992. She quizzed me about all the meds I've been on over the years. Then she ordered a whole new set of labs.
Viral load had jumped to 160. She said I could stay on Dovato and see if the viral load might go down, as I haven't missed any doses. I didn't like that idea. She agreed saying that since I was on 3TC in the past, it probably wasn't working anymore. She said the best bet was to go back on Biktarvy. First thing I asked was about weight gain. She said in her practice she commonly sees patients gain 30 pounds after switching to Biktarvy. I am to monitor my weight at home and weekly report it to her office.

I may call and ask about switching back to Truvada and Tivicay. Those didn't give me any problems. This new doctor isn't yet prescribing the new monthly injectable combo. She said it may be an option soon.

I hope this gives you some info. 

Offline TexasDragon

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  • Posts: 114
Re: Switching from Biktarvy to Dovato
« Reply #4 on: March 26, 2021, 06:51:42 am »
Texland -

Thanks for sharing - thank you all for sharing.

I was dxí ed in 2018 and started on Biktarvy right away. I have not taken any other meds. That is one reason she is considering a switch to Dovato - as you say I have not been on any of its components before. The only issue I have had with Biktarvy is an elevated bilirubin they deemed medically insignificant.

I just had an appointment with her and we discussed at length. I had my regular blood draw done. Once all that comes back, we will make a final decision. I am leaning toward making the switch.

Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20
09-29-2020 Blood Draw - CD4 972 32% VL <20
03-25-2021 Blood Draw - CD4 1168 38% VL = 26

Offline Texland

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  • Posts: 40
Re: Switching from Biktarvy to Dovato
« Reply #5 on: March 26, 2021, 05:40:16 pm »
TexasDragon - It sounds like you are the ideal candidate for Dovato. Best of luck with it, if you decide to switch!

Offline TexasDragon

  • Member
  • Posts: 114
Re: Switching from Biktarvy to Dovato
« Reply #6 on: March 29, 2021, 10:57:08 pm »
Well, we are making the switch from Biktarvy to Dovato next month.

My blood work came back fine. There was a slight up tick in my VL to 26 but there is a reason for that. I had a bad bicycle crash the end of February and fractured my femur. Long story short, I have a rod in my femur my knee to my hip. I missed a day after the accident and my times got all crazy the four days I was in the hospital. My doctor has no concerns.

I am beck to peddling on a trainer now and start on my Nordic track on Wednesday and I hope to get to two hours a day pretty quick. Recovery has gone smooth but not painless - keeping moving they say, and I have.

Iíll keep you posted. Know I care.
Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20
09-29-2020 Blood Draw - CD4 972 32% VL <20
03-25-2021 Blood Draw - CD4 1168 38% VL = 26

Offline Jim Allen

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Re: Switching from Biktarvy to Dovato
« Reply #7 on: March 29, 2021, 11:13:34 pm »
Quote
I had a bad bicycle crash the end of February and fractured my femur. Long story short, I have a rod in my femur my knee to my hip.

Quote
I am beck to peddling on a trainer now and start on my Nordic track on Wednesday and I hope to get to two hours a day pretty quick. Recovery has gone smooth but not painless - keeping moving they say, and I have.

That's a nasty break and sorry to hear about the crash, wishing you a quick recovery.
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Offline TexasDragon

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  • Posts: 114
Re: Switching from Biktarvy to Dovato
« Reply #8 on: March 29, 2021, 11:43:01 pm »
Thank you, Jim.

It has been rough - more so mentally than physically I would say. Patience is not my strong suite.

Know you are much appreciated by us all.
Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20
09-29-2020 Blood Draw - CD4 972 32% VL <20
03-25-2021 Blood Draw - CD4 1168 38% VL = 26

Offline Texland

  • Member
  • Posts: 40
Re: Switching from Biktarvy to Dovato
« Reply #9 on: March 31, 2021, 03:56:53 pm »
Ouch! Breaking your femur is serious. It sounds like you are healing quickly.

On the plus side, you'll be able to predict bad weather.

I hope you're back to 100% soon.

Offline TexasDragon

  • Member
  • Posts: 114
Re: Switching from Biktarvy to Dovato
« Reply #10 on: March 31, 2021, 04:23:20 pm »
Thank you Texland - no cane today!

Not perfect, but progress!
Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20
09-29-2020 Blood Draw - CD4 972 32% VL <20
03-25-2021 Blood Draw - CD4 1168 38% VL = 26

 


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