There was a trend towards a higher risk of discontinuation due to any reason in patients 50 years ( em n /em ?=?47/274; 17.2%) vs. 2014 in Germany. Safety and efficacy outcomes of RAL-based antiretroviral therapy (ART) in a population enriched for aging patients (total em N /em ?=?451, 50 years: em n /em ?=?274; 61%) were documented. Detailed methods and efficacy results have been published previously in this journal.4 The median time since HIV diagnosis was 10.5 (8.2) years. The median observed duration of ART with RAL was 344 days (range 25C511 days); 382/451 patients (84.7%) were male, 96 (21.3%) were previously untreated. Sixty-seven patients ( em n /em ?=?67/451; 14.9%) discontinued RAL during the observation period. With Curculigoside the possibility to report multiple reasons, the reasons for discontinuation were lack of efficacy ( em n /em ?=?26; 5.8%), AEs CENPA ( em n /em ?=?22; 4.9%), ART switch for unknown reasons ( em n /em ?=?19; 4.2%), poor compliance ( em n /em ?=?5; 1.1%) and other reasons ( em n /em ?=?34; 7.5%). There was a trend towards a higher risk of discontinuation due to any reason Curculigoside in patients 50 years ( em n /em ?=?47/274; 17.2%) vs. 50 years ( em n Curculigoside /em ?=?20/177; 11.3%). The difference did however not reach statistical significance. Regarding gender, no difference in discontinuation due to any reason was observed (male: em n /em ?=?58/382; 15.2% vs. female: em n /em ?=?9/69; 13.1%). Of the 22 discontinuations due to AEs, only 2 (0.4%) occurred within the first 100 days of RAL therapy (abdominal pain, hepatic enzyme increase). In four patients, AEs were classified as unrelated to RAL: hepatic failure ( em n /em ?=?1) and cancer ( em n /em ?=?3). All four patients died within two days after discontinuation. The remaining 18 (4.0%) patients discontinued RAL due to AEs possibly related to RAL. In sevena (1.6%) patients the documented reasons for discontinuation were neuropsychiatric disorders and in fourb (0.9%) patients gastrointestinal disturbances. The proportion of discontinuations due to AEs did not differ by age group (50 years: em n /em ?=?16/274; 5.8% vs. 50 years: em n /em ?=?6/177; 3.4%) or gender (male: em n /em ?=?18/382; 4.7% vs. female em n /em ?=?4/69; 5.8%). The findings from this analysis of observational data could be subject to channelling bias regarding the selection of a RAL-based regimen for patients with more comorbidities and concomitant medications or to reporting bias regarding AEs and their relationship to medication. During part of the observation period RAL was the only INI available in Germany, so that patients might have been more motivated to accept tolerability issues due to the lack Curculigoside of alternatives in the same drug-class. Further, comparisons across different cohort analyses should be interpreted with caution. In this large German real-life cohort, discontinuations due to neuropsychiatric AEs potentially related to RAL-based therapy were observed infrequently. This is consistent with recently published data5 and considerably lower than observed with dolutegravir under real-world conditions in Germany.1 Notes aNeuropsychiatric events in seven subjects: headache (1), dizziness (4), mood swings (1), depressed mood (1), personality disorder (1), depersonalization (1), disturbance of attention (1). bGastrointestinal events in four subjects: abdominal pain (1), gastric ulcer haemorrhage (1), vomiting (1), anorectal discomfort (1), nausea (1), dyspepsia (1). Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The Curculigoside authors received no financial support for the research, authorship, and/or publication of this article..