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

Better Adherence with Once‐Daily Antiretroviral Regimens: A Meta‐Analysis

“…Better adherence to once-daily versus twice-daily regimens remained statistically significant in all 11 sensitivity analyses conducted, after we excluded 1 individual study (data not shown). Ten studies [7–10, 12–14, 16–18], which represented 2452 subjects, reported virologic end points. The meta-analysis found no significant difference in the proportion of subjects who achieved HIV RNA levels <50 copies/mL (+2.2%; 95% CI −1.2 to 5.5; P =.21) between recipients of once-daily versus twice-daily regimens (figure 2).…”

“…Among the 5 trials of treatment-naive subjects [9–12, 15] (1927 patients), use of once-daily regimens significantly improved adherence (+4.4%; 95% CI, 1.8%−7.0%; P < .001) and was associated with better virologic outcome (+5.7%; 95% CI, 0.7%−10.8%; P < .027). In contrast, among the 6 trials [7, 8, 13, 14, 16, 17] that involved treatment-experienced subjects (1102 patients), the adherence effect size was not statistically significant (+1.0%; 95% CI, −0.8 to 2.8; P =.29) and did not correspond to better virologic outcome (−0.7%; 95% CI, −5.2 to 3.8; P =.76).…”

“…Six studies [8, 10, 12, 14–16] investigated (1657 patients) a regimen that consisted entirely of medications with once-daily administration. In this subgroup, use of the once-daily regimens were associated with significantly improved adherence (+4.5%; 95% CI, 1.5%−7.5%; P < .004) and better virologic outcome (+5.7%; 95% CI, 1.4%−10.0%; P < .001).…”