Highlights from the 10th European AIDS Conference (EACS):
A CME Newsletter
All visitors
to HIV and Hepatitis.com are welcome to read this newsletter, which
offers expert commentary on new developments in anti-HIV therapy
highlighted at the 10th EACS meeting held in Dublin, Ireland
November 17-20, 2005. However, only physicians and other medical
professionals may earn CME
credit
for this educational activity, which is designed for physicians,
physician assistants, nurse practitioners, and allied health professionals
who treat individuals with HIV. This CME activity is sponsored by
The Foundation for Better Health Care (FBHC) and supported by an
educational grant to FBHC from Gilead Sciences.
Following are
excerpts from the study results discussed in the CME newsletter
by Brian Boyle, MD, JD, Richard Elion,
MD, and Graeme Moyle, MD,
MS, BS:
Long-term Durability of Lopinavir/Ritonavir
(Kaletra)
The
durability data, derived from the Abbott 720 trial (M97-720), is
one of the primary reasons that lopinavir/ritonavir (LPV/r) [Kaletra] is included as a preferred protease
inhibitor (PI) under the Department of Health and
Human Services and International AIDS Society guidelines for treatment
of ARV-naïve patients.
In
that single-arm trial, 100 antiretroviral (ARV)-naïve patients were
treated with LPV/r + stavudine (d4T) [Zerit] + lamivudine (3TC) [Epivir]. The 360-week data from this trial
were presented, and at that time point, 61% of patients remained
<50 c/mL using an intent-to-treat (ITT),
noncompleters equals failure (ITT, NC=F)
analysis. Click
here to read more
Benefits of Substituting
TDF/FTC (Truvada) for ZDV/3TC (Combivir)
In
the ongoing COMET
cohort study, individuals currently receiving Combivir together with efavirenz (EFV) [Sustiva] for a minimum of 8 weeks and with a HIV RNA <400 c/ml were
switched to a once daily combination of Truvada (co-formulated TDF + FTC)
and EFV.
An
important finding from this trial is the improvement in suppression
to <50 c/mL that occurred following
the switch from Combivir to Truvada. While at baseline only 59% of the enrolled individuals
had an HIV RNA <50 c/mL, 24 weeks after
the switch to Truvada, 76% had an HIV
RNA <50 c/mL (P < .001). In addition
to the virologic benefit, benefits were also shown regarding tolerability
and toxicity. Click
here to read more
Efficacy of Efavirenz (Sustiva) in Highly Immunosuppressed
Patients
There
have been reports indicating that PI- and efavirenz
(EFV)-based HAART perform equally well in highly immunosuppressed
patients. In a prospective, randomized study, 65 patients with baseline
CD4 counts <100 cells/mm3 were randomized to receive either EFV
(n = 34) or indinavir (IDV) /ritonavir (RTV) (n = 31) with a backbone of zidovudine (ZDV) [Retrovir] + 3TC [Epivir]. The percentage of patients achieving
an HIV RNA <200 c/mL at 24 months,
using ITT, missing equals failure (ITT, M=F) and on treatment (OT)
analyses, and the on treatment CD4 count (cells/mm3) increase at
24 months, are shown in Table 2.Click
here to read more
Switching within the PI Class
The
SWAN
study, a multicenter,
randomized, comparative study, investigated substitution of atazanavir (ATV) [Reyataz] for a ritonavir (RTV)-boosted (54%)
or non-RTV-boosted (46%) PI in 407 individuals
with an HIV RNA <50 c/mL. The
primary endpoint in the study was virologic
failure, defined as rebound in HIV-1 RNA to >50 c/mL,
and this was observed in 7% of individuals who switched to ATV compared
with 16% in the continuation group (P <.01). Click
here to read more
Other Topics from the 10th EACS Reviewed in
the CME Newsletter:
Are
3TC and FTC the Same?
Potential Efficacy of EFV + ddI EC + 3TC Once-Daily
Problems With
NRTI-Sparing Regimens
A Hidden Cost of Generics?
Improvement in Limb Fat with Substitution
for Thymidine Analog
HAART Impact on Progression of Liver Fibrosis
11/23/05
Source
Foundation
for Better Health Care. 10th European AIDS Conference: A CME Newsletter
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