Pilot Study of Once-Daily Simplification Therapy with Abacavir/Lamivudine/Zidovudine and Efavirenz for Treatment of HIV-1 Infection

Abstract

In this pilot study of patients suppressed on abacavir/lamivudine/zidovudine bid plus EFV, 94% of participants switching to abacavir/lamivudine/zidovudine qd plus EFV maintained virologic suppression, compared to 89% of participants continuing abacavir/lamivudine/zidovudine bid plus EFV.

Twice-daily versus once-daily antiretroviral therapy and coformulation strategies in HIV-infected adults: benefits, risks, or burden?

“…Since simpler antiretroviral regimens are considered easier to follow and result in improved patient adherence, over the last decade the trend has been to simplify treatment regimens 9. The key objectives of this strategy are to reduce the overall pill burden (from >2–5 daily to one daily) and the number of times per day pills must be taken (eg, from three times daily to once daily) while maintaining virologic efficacy and treatment tolerability 10,11…”

“…In a meta-analysis of 11 randomized controlled trials involving a total of 3029 subjects, the impact of once-daily regimens on treatment adherence was evaluated. Adherence rates were modestly better with once-daily regimens (+2.9%, 95% confidence interval [CI]: 1.0%–4.8%; P < 0.003) than with twice-daily regimens,11 providing support for the use of once-daily regimens to help improve patient adherence. However, week 48 treatment outcomes as measured by virologic suppression were comparable between once-daily versus twice-daily regimens (77% vs 76%, respectively; P = 0.21).…”

TMC278 (Rilpivirine): A Next‐Generation NNRTI in Phase III Clinical Development for Treatment‐Naive Patients

“…Evidence is emerging to suggest that simplification of treatment can influence outcomes and enable patients to maintain virologic suppression at least as effectively upon switching to less complex treatment schedules [50]. TMC278 is a small tablet that is given once daily, and as well as the fixed-dose combination with TDF/FTC in development, it could be used in the future in fixed-dose combinations with a range of other ARVs for once-daily dosing.…”

Once-Daily Abacavir in Place of Twice-Daily Administration

“…Other studies investigated new roles for abacavir while comparing the dosing regimens. CAL30001 24,25 and Ruane et al 26 compared once- and twice-daily abacavir in 4-drug regimens for which there are no current recommendations (Table 1).…”