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Monday 22 October 2018
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First darunavir-based single-tablet regimen for the treatment of HIV-1 recommended for approval

Janssen-Cilag International NV has announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has issued a positive opinion recommending marketing authorisation for darunavir/cobicistat/emtricitabine/tenofovir alafenamide fumarate (D/C/F/TAF) (Symtuza), a new once-daily darunavir-based single tablet regimen (STR).

If approved, it will be the only darunavir-based STR indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and adolescents aged 12 years and older with body weight of at least 40 kg. This STR combines the proven efficacy and durability of darunavir with the improved renal laboratory and bone mineral density profile of F/TAF as compared to F/TDF (tenofovir disoproxil fumarate), and will be the only treatment that could deliver the adherence advantages of an STR coupled with the high genetic barrier to resistance that darunavir offers.1


Darunavir is one of the most widely used HIV treatments in the European Union due to its ability to control the HIV virus while offering a high barrier to resistance. We will now be able to combine a complete darunavir-based HIV treatment regimen into a once daily tablet. We are extremely excited to be one step closer to getting this therapy to people living with HIV and in doing so hope to reduce the treatment burden faced by many living with the virus,” said Lawrence M Blatt, PhD, Global Therapeutic Area Head, Janssen Infectious Diseases Therapeutics.


A darunavir-based STR represents a significant evolution in treatment options for HIV patients,” said Jean-Michel Molina, Professor of Infectious Diseases at the University of Paris Diderot. “With around two million people in Europe currently managing their HIV, this is a true advancement in helping patients achieve an undetectable viral load and improving quality of life. Reducing the pill burden allows people greater freedom and flexibility, and through this we may also improve treatment adherence.”


The positive opinion is based on a bioequivalence study comparing the once-daily STR with the combined administration of the separate agents darunavir [D] 800 mg, cobicistat [C] 150 mg, and emtricitabine/tenofovir alafenamide [FTC/TAF] 200 mg/10 mg fixed-dose combination.1 A Phase III clinical trial programme investigating the efficacy and safety of the darunavir-based combination is underway.2,3 Data on the bioequivalence study, as well as interim data from the Phase III Pivotal EMERALD trial in virologically suppressed antiretroviral therapy (ART) experienced patients who were switched to the STR, will be presented at the upcoming International AIDS Society (IAS) conference in Paris, France.1 Further EMERALD 48-week data, and 48-week data from the Phase III AMBER trial in ART naïve patients, will be released in due course.2,3



  1. Crauwels HM et al. Bioequivalence of a Darunavir-based Single-Tablet Complete HIV-1 regimen Compared to the Separate Agents. International Aids Society Conference, July 2017
  2. NCT02269917. Available at: Last accessed July 2017
  3. NCT02431247. Available at: Last accessed July 2017

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