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Survival analyses were performed to estimate the probability of virological failure (VF, defined as one HIV\u00a0RNA\u00a0&gt;\u00a01000 copies\/mL or two consecutive HIV\u00a0RNA\u00a0&gt;\u00a050 copies\/mL) and treatment discontinuation (TD, defined as any modification, intensification or interruption of the regimen), and to evaluate their predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1666 patients were included, of whom 1334 (80%) were treated with a 3DR (19.9%, 25.0% and 55.1% elvitegravir\u2010, raltegravir\u2010 and dolutegravir\u2010based, respectively) and 332 (20%) with a 2DR (79.2% dolutegravir\u00a0+\u00a0lamivudine and 20.8% dolutegravir\u00a0+\u00a0rilpivirine).<\/jats:p><jats:p>Over a median (interquartile range) follow\u2010up of 100\u00a0(52\u2013150) weeks, 52 (3.1%) patients experienced VF with an incidence of 1.5\/100 person\u2010year of follow\u2010up (PYFU). The estimated 96\u2010week probability of VF was similar for the 2DR and 3DR groups (2.3% <jats:italic>vs<\/jats:italic>. 2.8%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.53), but it was higher for elvitegravir (4.9%) and raltegravir (5.0%) than for dolutegravir (1.5%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04).<\/jats:p><jats:p>Four hundred (24%) patients discontinued their InSTI\u2010based regimen, with an incidence of 11.3\/100 PYFU. At 96 weeks, 3DRs showed a higher probability of TD for any reason (20.6% <jats:italic>vs<\/jats:italic>. 11.2%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and TD for toxicity (9.0% <jats:italic>vs<\/jats:italic>. 6.6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02) when compared with 2DRs. A higher risk of TD for central nervous system toxicity was observed for dolutegravir than for elvitegravir and raltegravir (4.0% <jats:italic>vs<\/jats:italic>. 2.5% <jats:italic>vs<\/jats:italic>. 0.6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In virologically suppressed HIV\u2010infected patients, 2DRs showed an efficacy similar to 3DRs but with better tolerability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13146","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T03:43:58Z","timestamp":1627443838000},"page":"843-853","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Efficacy and durability of two\u2010 <i>vs<\/i>. three\u2010drug integrase inhibitor\u2010based regimens in virologically suppressed HIV\u2010infected patients: Data from real\u2010life ODOACRE cohort"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1343-812X","authenticated-orcid":false,"given":"Massimiliano","family":"Fabbiani","sequence":"first","affiliation":[{"name":"UOC Malattie Infettive e Tropicali Azienda Ospedaliero\u2010Universitaria Senese Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1659-9241","authenticated-orcid":false,"given":"Barbara","family":"Rossetti","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive e Tropicali Azienda Ospedaliero\u2010Universitaria Senese Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5941-883X","authenticated-orcid":false,"given":"Arturo","family":"Ciccullo","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive Fondazione Policlinico Universitario A. 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