PittsburghV1, France, Analysis, bibRecord, 000321

Lower Pill Burden and Once-Daily Antiretroviral Treatment Regimens for HIV Infection: A Meta-Analysis of Randomized Controlled Trials

Identifieur interne : 000321 ( France/Analysis ); précédent : 000320; suivant : 000322

Lower Pill Burden and Once-Daily Antiretroviral Treatment Regimens for HIV Infection: A Meta-Analysis of Randomized Controlled Trials

Auteurs : Jean B. Nachega [États-Unis, Afrique du Sud] ; Jean-Jacques Parienti [France] ; Olalekan A. Uthman [Royaume-Uni, Afrique du Sud] ; Robert Gross [États-Unis] ; David W. Dowdy [États-Unis] ; Paul E. Sax [États-Unis] ; Joel E. Gallant [États-Unis] ; Michael J. Mugavero [États-Unis] ; Edward J. Mills [Canada] ; Thomas P. Giordano [États-Unis]

Source :

Clinical infectious diseases [ 1058-4838 ] ; 2014.

RBID : Pascal:14-0137144

Descripteurs français

KwdFr :
- Adulte, Agents antiVIH (administration et posologie), Agents antiVIH (usage thérapeutique), Charge virale, Essais contrôlés randomisés comme sujet, Humains, Infections à VIH (traitement médicamenteux), Observance thérapeutique.
MESH :
- administration et posologie : Agents antiVIH.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
Pascal (Inist)
- Adulte, Charge virale, Essais contrôlés randomisés comme sujet, Humains, Observance thérapeutique, SIDA, Traitement.

English descriptors

KwdEn :
- AIDS, Adult, Anti-HIV Agents (administration & dosage), Anti-HIV Agents (therapeutic use), HIV Infections (drug therapy), Humans, Patient Compliance, Randomized Controlled Trials as Topic, Treatment, Viral Load.
MESH :
- chemical , administration & dosage : Anti-HIV Agents.
- chemical , therapeutic use : Anti-HIV Agents.
- drug therapy : HIV Infections.
- Adult, Humans, Patient Compliance, Randomized Controlled Trials as Topic, Viral Load.

Abstract

Background. Contemporary antiretroviral treatment regimens are simpler than in the past, with lower pill burden and once-daily dosing frequency common. We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the impact of pill burden and once-daily vs twice-daily dosing on ART adherence and virological outcomes. Methods. A literature search of 4 electronic databases through 31 March 2013 was used. RCTs comparing once-daily vs twice-daily ART regimens that also reported on adherence and virological suppression were included. Study design, study population characteristics, intervention, outcome measures, and study quality were extracted. Study quality was rated using the Cochrane risk-of-bias tool. Results. Nineteen studies met our inclusion criteria (N = 6312 adult patients). Higher pill burden was associated with both lower adherence rates (P = .004) and worse virological suppression (P < .0001) in both once-daily and twice-daily subgroups, although the association with adherence in the once-daily subgroup was not statistically significant. The average adherence was modestly higher in once-daily regimens than twice-daily regimens (weighted mean difference = 2.55%; 95% confidence interval [CI], 1.23 to 3.87; P = .0002). Patients on once-daily regimens did not achieve virological suppression more frequently than patients on twice-daily regimens (relative risk [RR] = 1.01; 95% CI, 0.99 to 1.03; P = .50). Both adherence and viral load suppression decreased over time, but adherence decreased less with once-daily dosing than with twice-daily dosing. Conclusions. Lower pill burden was associated with both better adherence and virological suppression. Adherence, but not virological suppression, was slightly better with once- vs twice-daily regimens.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982838

Affiliations:

Links to Exploration step

Pascal:14-0137144

Le document en format XML

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<term>HIV Infections (drug therapy)</term>
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<term>Viral Load</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Agents antiVIH (administration et posologie)</term>
<term>Agents antiVIH (usage thérapeutique)</term>
<term>Charge virale</term>
<term>Essais contrôlés randomisés comme sujet</term>
<term>Humains</term>
<term>Infections à VIH (traitement médicamenteux)</term>
<term>Observance thérapeutique</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-HIV Agents</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents antiVIH</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents antiVIH</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Humans</term>
<term>Patient Compliance</term>
<term>Randomized Controlled Trials as Topic</term>
<term>Viral Load</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term>
<term>Charge virale</term>
<term>Essais contrôlés randomisés comme sujet</term>
<term>Humains</term>
<term>Observance thérapeutique</term>
<term>SIDA</term>
<term>Traitement</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background. Contemporary antiretroviral treatment regimens are simpler than in the past, with lower pill burden and once-daily dosing frequency common. We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the impact of pill burden and once-daily vs twice-daily dosing on ART adherence and virological outcomes. Methods. A literature search of 4 electronic databases through 31 March 2013 was used. RCTs comparing once-daily vs twice-daily ART regimens that also reported on adherence and virological suppression were included. Study design, study population characteristics, intervention, outcome measures, and study quality were extracted. Study quality was rated using the Cochrane risk-of-bias tool. Results. Nineteen studies met our inclusion criteria (N = 6312 adult patients). Higher pill burden was associated with both lower adherence rates (P = .004) and worse virological suppression (P < .0001) in both once-daily and twice-daily subgroups, although the association with adherence in the once-daily subgroup was not statistically significant. The average adherence was modestly higher in once-daily regimens than twice-daily regimens (weighted mean difference = 2.55%; 95% confidence interval [CI], 1.23 to 3.87; P = .0002). Patients on once-daily regimens did not achieve virological suppression more frequently than patients on twice-daily regimens (relative risk [RR] = 1.01; 95% CI, 0.99 to 1.03; P = .50). Both adherence and viral load suppression decreased over time, but adherence decreased less with once-daily dosing than with twice-daily dosing. Conclusions. Lower pill burden was associated with both better adherence and virological suppression. Adherence, but not virological suppression, was slightly better with once- vs twice-daily regimens.</div>
</front>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Canada</li>
<li>France</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Basse-Normandie</li>
<li>Maryland</li>
<li>Massachusetts</li>
<li>Nouveau-Mexique</li>
<li>Pennsylvanie</li>
<li>Région Normandie</li>
<li>Texas</li>
</region>
<settlement><li>Caen</li>
</settlement>
<orgName><li>Université de Caen Basse-Normandie</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B." last="Nachega">Jean B. Nachega</name>
</region>
<name sortKey="Dowdy, David W" sort="Dowdy, David W" uniqKey="Dowdy D" first="David W." last="Dowdy">David W. Dowdy</name>
<name sortKey="Gallant, Joel E" sort="Gallant, Joel E" uniqKey="Gallant J" first="Joel E." last="Gallant">Joel E. Gallant</name>
<name sortKey="Giordano, Thomas P" sort="Giordano, Thomas P" uniqKey="Giordano T" first="Thomas P." last="Giordano">Thomas P. Giordano</name>
<name sortKey="Gross, Robert" sort="Gross, Robert" uniqKey="Gross R" first="Robert" last="Gross">Robert Gross</name>
<name sortKey="Mugavero, Michael J" sort="Mugavero, Michael J" uniqKey="Mugavero M" first="Michael J." last="Mugavero">Michael J. Mugavero</name>
<name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B." last="Nachega">Jean B. Nachega</name>
<name sortKey="Sax, Paul E" sort="Sax, Paul E" uniqKey="Sax P" first="Paul E." last="Sax">Paul E. Sax</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B." last="Nachega">Jean B. Nachega</name>
</noRegion>
<name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B." last="Nachega">Jean B. Nachega</name>
<name sortKey="Uthman, Olalekan A" sort="Uthman, Olalekan A" uniqKey="Uthman O" first="Olalekan A." last="Uthman">Olalekan A. Uthman</name>
</country>
<country name="France"><noRegion><name sortKey="Parienti, Jean Jacques" sort="Parienti, Jean Jacques" uniqKey="Parienti J" first="Jean-Jacques" last="Parienti">Jean-Jacques Parienti</name>
</noRegion>
<name sortKey="Parienti, Jean Jacques" sort="Parienti, Jean Jacques" uniqKey="Parienti J" first="Jean-Jacques" last="Parienti">Jean-Jacques Parienti</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Uthman, Olalekan A" sort="Uthman, Olalekan A" uniqKey="Uthman O" first="Olalekan A." last="Uthman">Olalekan A. Uthman</name>
</noRegion>
<name sortKey="Uthman, Olalekan A" sort="Uthman, Olalekan A" uniqKey="Uthman O" first="Olalekan A." last="Uthman">Olalekan A. Uthman</name>
</country>
<country name="Canada"><noRegion><name sortKey="Mills, Edward J" sort="Mills, Edward J" uniqKey="Mills E" first="Edward J." last="Mills">Edward J. Mills</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Lower Pill Burden and Once-Daily Antiretroviral Treatment Regimens for HIV Infection: A Meta-Analysis of Randomized Controlled Trials

Lower Pill Burden and Once-Daily Antiretroviral Treatment Regimens for HIV Infection: A Meta-Analysis of Randomized Controlled Trials

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