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Journal of the International AIDS Society

Open Access

Pooled week 48 safety and efficacy results from the ECHO and THRIVE phase III trials comparing TMC278 vs EFV in treatment-naïve, HIV-1-infected patients

  • C Cohen1,
  • JM Molina2,
  • P Cahn3,
  • B Clotet4,
  • J Fourie5,
  • B Grinsztejn6,
  • W Hao7,
  • M Johnson8,
  • K Supparatpinyo9,
  • HM Crauwels10,
  • L Rimsky10,
  • S Vanveggel10,
  • P Williams10 and
  • K Boven11
Journal of the International AIDS Society201013(Suppl 4):O48

Published: 8 November 2010


Pooled 48-week primary analysis results of two double-blind, randomised, TMC278 Phase III trials, ECHO (TMC278-C209, NCT00540449) and THRIVE (TMC278-C215, NCT00543725), are presented.


Treatment-naïve adult patients (N=1368) received (1:1) TMC278 25mg qd or EFV 600mg qd, plus TDF/FTC (ECHO), or TDF/FTC, AZT/3TC or ABC/3TC (THRIVE). The primary objective was to demonstrate non-inferiority (12% margin) of TMC278 to EFV in confirmed virologic response (viral load [VL] <50 copies/mL ITT-TLOVR algorithm) at Week 48.


Overall virologic response rates at Week 48 were high (Figure 1).TMC278 showed non-inferior efficacy versus EFV. The impact of adherence, in addition to other factors, such as baseline viral load and exposure, on virologic response will be presented. Incidences of the following tolerability measures were significantly lower in the TMC278 group than in the EFV group: adverse events (AEs) leading to discontinuation (3% vs. 8%, respectively; p=0.0005), grade 2-4 AEs at least possibly related to treatment (16% vs. 31%; p<0.0001), rash (3% vs 14%; p<0.0001), dizziness (8% vs. 26%; p<0.0001), abnormal dreams/nightmare (8% vs. 13%; p=0.0061), and grade 3/4 laboratory abnormalities for lipids (p≤0.001).

Figure 1


At Week 48, TMC278 demonstrated a high virologic response rate (≥83%) and non-inferior efficacy versus EFV when administered with NRTIs in both Phase III trials. The virologic failure rate was significantly higher with TMC278, while the incidences of AEs leading to discontinuation were significantly lower with TMC278. Grade 2-4 AEs at least possibly related to treatment were half as frequent with TMC278 compared with EFV. In addition, incidences of dizziness, abnormal dreams/nightmare and rash were significantly lower for TMC278, and TMC278 had significantly fewer grade 3/4 lipid abnormalities than EFV.

Authors’ Affiliations

Community Research Initiative of New England
Saint-Louis Hospital and University of Paris, Department of Infectious Diseases
Hospital Juan A Fernández and Fundación Huesped
Hospital Universitari Germans Trias i Pujol and irsiCaixa Foundation, UAB
Dr J Fourie Medical Centre
Instituto de Pesquisa Clínica Evandro Chagas-Fiocruz
Beijing You’an Hospital
Royal Free Hospital
Chiang Mai University, Section of Infectious Disease
Tibotec BVBA
Tibotec Inc


© Cohen et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.