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Data regarding the impact of combination of those drugs on Cr-eGFR, in the clinical practice, are scarcely known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Changes in Cr-eGFR after starting darunavir\/cobicistat alone or in combination with dolutegravir and\/or rilpivirine were studied in a nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir\/cobicistat. The relationship between Cr-eGFR changes over time and the use of darunavir\/cobicistat alone or darunavir\/cobicistat plus dolutegravir and\/or rilpivirine adjusted by different HIV patient\u2019s characteristics, socio-demographics, HIV severity and use of tenofovir concomitant medication other than antiretrovirals was explored through univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis included 725 patients. At 48\u2009weeks, the combination of two or more IPTCrS (darunavir\/cobicistat with rilpivirine and\/or dolutegravir) was associated with higher decreases in Cr-eGFR [adjusted median difference (\u00b1SD) \u20133.5\u2009\u00b1\u20091.6 (95% CI \u20136.6 to \u20130.3), P\u2009=\u20090.047], and a decrease up to or higher than 15\u2009mL\/min\/1.73\u2009m2 was more frequent [adjusted OR 3.233 (95% CI 1.343\u20137.782), P\u2009=\u20090.009], with respect to darunavir\/cobicistat alone. The Cr-eGFR changes between darunavir\/cobicistat and darunavir\/cobicistat with rilpivirine and\/or dolutegravir showed more significant decreases in patients taking two or more IPTCrS at 12, 24 and 48\u2009weeks. (ClinicalTrials.gov: NCT03042390).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Concomitant use of darunavir\/cobicistat plus IPTCrS dolutegravir, rilpivirine, or both produced an additive effect in the expected Cr-eGFR decrease.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkaa547","type":"journal-article","created":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T04:22:22Z","timestamp":1608006142000},"page":"1046-1050","source":"Crossref","is-referenced-by-count":4,"title":["Dynamics of creatinine estimated glomerular filtration rate using one or more antiretrovirals that inhibit creatinine tubular secretion"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5700-5257","authenticated-orcid":false,"given":"Maria Jesus","family":"Perez Elias","sequence":"first","affiliation":[{"name":"Hospital Ram\u00f3n y Cajal, IRYCIS, Madrid, 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