| Autor: |
Cahn, Pedro, Vibhagool, Asda, Schechter, Mauro, Soto-Ramirez, Luis, Carosi, Giampiero, Smaill, Fiona, Jordan, Jamie C., Pharo, Cristina E., Thomas, Nicola E., Steel, Helen M. |
| Zdroj: |
Current Medical Research and Opinion; July 01, 2004, Vol. 20 Issue: 7 p1115-1123, 9p |
| Abstrakt: |
SUMMARYObjectives:To compare dosing convenience and adherence with abacavir (ABC) 300 mg plus a fixed-dose lamivudine 150 mg/zidovudine 300 mg combination tablet (COM) twice daily versus indinavir (IDV) plus COM twice daily in treatment-naïve, HIV-1-infected adults; and to evaluate the association among difficulty taking antiretroviral regimens, adherence, and virologic efficacy.Methods:An open-label, randomized, multicenter, international study compared the COM/ABC and IDV/COM regimens with respect to self-reported adherence and regimen convenience over 48 weeks. Logistic regression analysis (LRA) was done on a patient sub-sample from both groups to evaluate predictors of adherence and virologic response at last time-point on randomized therapy (LTORT).Results:The study population was diverse with respect to ethnicity (38 Asian, 27 Hispanic, 28 white, 3 black, 4 other) and gender (39 women, 61 men). Baseline median HIV-1 RNA was 4.80 log10copies/mL and CD4 cell count was 315 cells/mm3. Of 329 patients who were randomized and received treatment, 315 (96) provided adherence data. Significantly more patients in the ABC/COM group than in the IDV/COM group reported ≥ 95 adherence to therapy (76 vs 58, p< 0.001) and no difficulty in taking their regimen (91 vs 61, p< 0.001). In both groups, the highest probability of HIV-1 RNA < 400 copies/mL occurred when median adherence was ≥ 95. The probability of HIV-1 RNA < 400 copies/mL declined more rapidly in the IDV/COM group as adherence rates decreased. LRA showed that no difficulty taking any of the drugs in the regimen, ABC/COM treatment group, and male gender were independent significant predictors of ≥ 95 adherence ( p< 0.05). Median adherence and baseline HIV-1 RNA were significant predictors of HIV-1 RNA < 400 copies/mL ( p< 0.05).Conclusions:Patients reported greater ease of use and superior adherence to ABC/COM than IDV/COM. Patient-reported difficulty taking drugs in a regimen was predictive of reduced adherence, and both of the latter factors were predictive of poorer virologic outcome. Adherence levels of ≥ 95 in both treatment groups maximized the probability of patients achieving an HIV-1 RNA < 400 copies/mL. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
