Evaluation of Inflammation and Atherogenesis Biomarkers Through 148 Weeks Post-Switch to Dolutegravir and Rilpivirine in SWORD-1/-2

Switching to the 2-drug regimen dolutegravir + rilpivirine demonstrated non-inferiority vs continuing a 3- or 4-drug current antiretroviral regimen (CAR) at Week 48 and maintained high levels of virologic suppression to Week 148 in the SWORD studies. We report inflammation and atherogenesis biomarkers post-switch to dolutegravir + rilpivirine.SWORD-1: 65 centers, 13 countries; SWORD-2: 60 centers, 11 countries.Virologically suppressed adults were randomized to switch to dolutegravir + rilpivirine (Early-Switch group; n=513) or continue CAR (n=511). Participants continuing CAR switched to dolutegravir + rilpivirine at Week 52 (Late-Switch group; n=477). Biomarkers were evaluated from Baseline to Week 48 for dolutegravir + rilpivirine and CAR, and non-comparatively for dolutegravir + rilpivirine post-switch through 148 weeks (Early-Switch) and 96 weeks (Late-Switch).Through Week 48, changes in biomarkers did not significantly differ between dolutegravir + rilpivirine and CAR groups, except for increases in soluble CD14 and decreases in fatty acid binding protein-2, which favored dolutegravir + rilpivirine. For inflammation biomarkers through Week 148, there was no marked change in C-reactive protein, inconsistent changes in soluble CD14 and interleukin-6, and increases in soluble CD163. For atherogenesis biomarkers through Week 148, fatty acid binding protein-2 and soluble vascular cell adhesion molecule-1 showed sustained reductions; D-dimer showed inconsistent increases between Early- vs Late-Switch groups.No consistent pattern of change in biomarkers post-switch to dolutegravir + rilpivirine was observed through Weeks 48 and 148 in SWORD-1/-2, suggesting no association of increased inflammation or atherogenesis with the 2-drug regimen while maintaining virologic suppression.