Análisis coste-eficacia de tenofovir versus zidovudina en terapia combinada con efavirenz y lamivudina para el tratamiento de VIH en pacientes no pretratados

Lisón, L.C. Fernández; Llave, E. Pujol de la; Alonso, Alicia; Martínez, María Teresa Garrido; Martín, C. Bocanegra

doi:10.1016/s1130-6343(05)73630-8

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…This finding is similar to the previous studies [8, 9, 14]. These findings reveal an increasing evidence on the superiority of TDF/FTC/EFV in terms of efficacy and tolerability as first line regimen for naïve HIV-1 infected adult patients and support the inclination toward the preference of TDF/FTC/EFV as initial ART regimen over ZDV/3TC/EFV, due to its cost effectiveness and lower pill burden, besides superior efficacy and better tolerability [18–21]. …”

Section: Discussionsupporting

confidence: 72%

Efficacy and Tolerability of Tenofovir Disoproxil Fumarate Based Regimen as Compared to Zidovudine Based Regimens: A Systematic Review and Meta-Analysis

Dadi

Kefale

Mega

et al. 2017

AIDS Research and Treatment

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Background Although tenofovir (TDF)/emtricitabine (FTC)/efavirenz (EFV) and zidovudine (ZDV)/lamivudine (3TC)/efavirenz (EFV) are used as preferred first line regimen, their head-to-head comparison in terms of their efficacy and tolerability was limited. This review aimed to synthesize the best available evidence on the comparative efficacy and tolerability of the two regimens. Methods Seven sites and databases in addition to Google search until August 20, 2016, were searched. Only randomized clinical trials conducted on adult population were included in this study. Our primary outcome was viral load suppression while secondary outcomes were death and tolerability. Undetectable viral load is defined as <50 Human Immunodeficiency Virus (HIV) ribonucleic acid (RNA) copies/ml. Joanna Briggs institute meta-analysis of statistics assessment and review instrument (JBI-MAStARI) and critical appraisal and data extraction tool were applied for critical assessment and data extraction, respectively. We performed a random effect meta-analysis to pool the relative risk (RR) for viral load suppression (<50 HIV RNA copies/ml and <400 HIV RNA copies/ml), tolerability, and death. Result Data was extracted from four articles, which included a total of 2381 participants. We found superior viral load suppression among tenofovir (TDF) arm compared to zidovudine (ZDV) arm. Tenofovir arm achieves viral load <50 HIV RNA copies/ml (RR = 1.12, 95% confidence interval (CI) [1.04, 1.21], I2 = 0%) higher than zidovudine arm. Similarly TDF arm is superior in viral load suppression to <400 HIV RNA copies/ml (RR = 1.19, 95% CI [1.11, 1.27], I2 = 0%). Moreover, TDF based regimens were more likely to be tolerated than ZDV based regimens (4 trials, 2381 participants (RR = 1.06, 95% CI [1.02, 1.10], I2 = 51%)). However, forest plot of death shows that it was not significant (RR = 0.91, 95% CI [0.51, 1.62]). Conclusion The use of TDF/FTC/EFV as first line regimen for naïve HIV-1 infected adult patient showed superior viral load suppression and tolerability as compared to ZDV/3TC/EFV. In order to compare the death outcome of both ZDV/3TC/EFV and TDF/FTC/EFV further research is needed.

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Section: Discussionsupporting

confidence: 72%

Efficacy and Tolerability of Tenofovir Disoproxil Fumarate Based Regimen as Compared to Zidovudine Based Regimens: A Systematic Review and Meta-Analysis

Dadi

Kefale

Mega

et al. 2017

AIDS Research and Treatment

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“…En vista a los resultados tenofovir supone un antirretroviral de gran efectividad en el hospital con un perfil de seguridad óptimo, excepto el renal. Esto le sitúa como una buena opción en el TARGA que también ha demostrado una buena relación coste efectividad (19).…”

Section: Discussionunclassified

Estudio de utilización de Tenofovir DF en el tratamiento antirretroviral de gran actividad

Lisón¹,

Domínguez²,

Gómez

et al. 2006

An. Med. Interna (Madrid)

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DF en el tratamiento antirretroviral de gran actividad. An Med Interna (Madrid) 2006; 23: 573-576. RESUMENObjetivo: Describir la eficacia y seguridad de tenofovir. Métodos: Estudio descriptivo, observacional. Análisis por intención de tratar. La variable principal fue la proporción de pacientes con supresión de la carga viral plasmática del VIH hasta indetectable. Las variables secundarias fueron la respuesta inmunológica, proporción de pacientes con variación positiva del número de CD4 + y la seguridad (eventos adversos clínicos y valores bioquímicos y hematológicos). Se midió la causalidad por el algoritmo de Naranjo.Resultados: Se seleccionaron 154 pacientes, 12 fueron excluidos de todos los análisis. Las variables de eficacia fueron: La proporción de pacientes que disminuyeron la carga viral a 50 copias/ml o menos fue 28,16%, la media de descenso fue -1,29 ± 0,97 log 10 copias/ml. La media de aumento de CD4 fue de 40,27 ± 141,50 cel/mm 3 La seguridad fue similar a la ficha técnica, destacando tres casos de Síndrome de Fanconi.Conclusión: Tenofovir supone un antirretroviral de gran efectividad en el hospital con un perfil de seguridad óptimo.

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Análisis coste-eficacia de tenofovir versus zidovudina en terapia combinada con efavirenz y lamivudina para el tratamiento de VIH en pacientes no pretratados

Abstract: The regimen including zidovudine is less costly in the short run when compared to the regimen including tenofovir. Both regimens become financially similar when extending the study horizon.

Cited by 2 publications

References 10 publications

Efficacy and Tolerability of Tenofovir Disoproxil Fumarate Based Regimen as Compared to Zidovudine Based Regimens: A Systematic Review and Meta-Analysis

Efficacy and Tolerability of Tenofovir Disoproxil Fumarate Based Regimen as Compared to Zidovudine Based Regimens: A Systematic Review and Meta-Analysis

Estudio de utilización de Tenofovir DF en el tratamiento antirretroviral de gran actividad

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