Long-term Efficacy and Tolerability of Regimens Containing Efavirenz (Sustiva) and Nevirapine (Viramune) Regimens

Viramune Tablet

Sustiva Tablet

Because of their favorable toxicity profile, low price, and ease of use, the non-nucleoside reverse transcriptase inhibitors (NNRTIs) efavirenz (Sustiva) and nevirapine (Viramune) are frequently used as part of antiretroviral therapy for HIV.

Several clinical trials have already studied the efficacy and tolerability of these agents, but data on long-term outcomes are limited.

In the current study, published May 28, 2008 in the online edition of AIDS Research and Human Retroviruses, French researchers used data from a prospective Senegalese cohort to analyze long-term tolerability and efficacy of these 2 drugs in a resource-limited setting.

Patients were included in the analysis if they started their antiretroviral therapy with either efavirenz or nevirapine. The primary endpoint was time to treatment discontinuation. Secondary endpoints included time to death, time to disease progression, severe adverse effects, CD4 cell recovery, and virological response.

Results

• The median follow-up time in both the efavirenz and nevirapine arms was 48 months.

• The hazard ratio of drug discontinuation in the efavirenz arm compared with the nevirapine arm was 0.84.

• There was a borderline significant difference in virological response between the 2 arms.

• However, there were no significant differences in time to death, time to AIDS progression, or time to attain a CD4 cell count above 500 cells/mm3.

• Adverse events differed between the efavirenz and nevirapine arms, but overall long-term tolerability was good for both drugs.

In conclusion, the study authors wrote, "This analysis provided further information on long-term tolerance and efficacy of efavirenz and nevirapine in a resource-limited setting."

Hospices Civils de Lyon, Service de Biostatistique, Lyon, France; Université de Lyon, Université Lyon I, Villeurbanne, France; CNRS, UMR 5558, Laboratoire Biostatistique Santé, Pierre-Bénite, France; Institut de Recherche pour le Développement, Montpellier, France.

6/13/08

Reference

P de Beaudrap, JF Etard, FN Gueye, and others (ANRS 1215/1290 Study Group). Long-term efficacy and tolerance of efavirenz- and nevirapine-containing regimens in adult HIV type 1 Senegalese patients. AIDS Research and Human Retroviruses. May 28, 2008 [Epub ahead of print].

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