A meta-analysis comparing 48-week treatment outcomes of single and multi-tablet antiretroviral regimens for the treatment of people living with HIV

Patrick Gerard Clay, Wei Cheng Yuet, Christiane H. Moecklinghoff, Inge Duchesne, Krzysztof L. Tronczyski, Sandip Shah, Dong Shao

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. Design: Systematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens. Methods: The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis. Double-blinded studies were excluded due to lack of difference in pill burden between cohorts. The key outcomes of interest included: adherence rates/proportion meeting target, efficacy, safety/tolerability, non-clinical and economic outcomes. Results: After screening 63 full-text articles and posters, 14 studies were eligible for the meta-analysis. The analysis showed that patients taking STR had improved outcomes over those taking MTR. Patients were significantly more adherent regardless of daily dosing frequency (odds ratio [OR]: 1.96, p<0.001) and were more likely to achieve virological suppression (relative risk [RR]: 1.05, p=0.002). There was a trend toward a lower discontinuation risk in the STR cohort, together with reported higher therapy satisfaction, better symptom control, improved health status, reduced healthcare resource utilization and demonstrated cost-effectiveness compared to MTR. There were no differences in CD4 cell count increase (at 48weeks) or safety outcomes. Conclusions: The findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.

Original languageEnglish
Article number17
JournalAIDS Research and Therapy
Volume15
Issue number1
DOIs
StatePublished - 30 Oct 2018

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Tablets
Meta-Analysis
HIV
Therapeutics
Cost-Benefit Analysis
Delivery of Health Care
Safety
Posters
CD4 Lymphocyte Count
Quality Improvement
Health Status
Odds Ratio
Economics
Quality of Life
Guidelines
Research

Keywords

  • Economics pharmaceutical
  • Human immunodeficiency virus
  • Quality of life
  • Treatment adherence and compliance
  • Treatment outcome

Cite this

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title = "A meta-analysis comparing 48-week treatment outcomes of single and multi-tablet antiretroviral regimens for the treatment of people living with HIV",
abstract = "Objectives: To compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. Design: Systematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens. Methods: The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis. Double-blinded studies were excluded due to lack of difference in pill burden between cohorts. The key outcomes of interest included: adherence rates/proportion meeting target, efficacy, safety/tolerability, non-clinical and economic outcomes. Results: After screening 63 full-text articles and posters, 14 studies were eligible for the meta-analysis. The analysis showed that patients taking STR had improved outcomes over those taking MTR. Patients were significantly more adherent regardless of daily dosing frequency (odds ratio [OR]: 1.96, p<0.001) and were more likely to achieve virological suppression (relative risk [RR]: 1.05, p=0.002). There was a trend toward a lower discontinuation risk in the STR cohort, together with reported higher therapy satisfaction, better symptom control, improved health status, reduced healthcare resource utilization and demonstrated cost-effectiveness compared to MTR. There were no differences in CD4 cell count increase (at 48weeks) or safety outcomes. Conclusions: The findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.",
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A meta-analysis comparing 48-week treatment outcomes of single and multi-tablet antiretroviral regimens for the treatment of people living with HIV. / Clay, Patrick Gerard; Yuet, Wei Cheng; Moecklinghoff, Christiane H.; Duchesne, Inge; Tronczyski, Krzysztof L.; Shah, Sandip; Shao, Dong.

In: AIDS Research and Therapy, Vol. 15, No. 1, 17, 30.10.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A meta-analysis comparing 48-week treatment outcomes of single and multi-tablet antiretroviral regimens for the treatment of people living with HIV

AU - Clay, Patrick Gerard

AU - Yuet, Wei Cheng

AU - Moecklinghoff, Christiane H.

AU - Duchesne, Inge

AU - Tronczyski, Krzysztof L.

AU - Shah, Sandip

AU - Shao, Dong

PY - 2018/10/30

Y1 - 2018/10/30

N2 - Objectives: To compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. Design: Systematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens. Methods: The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis. Double-blinded studies were excluded due to lack of difference in pill burden between cohorts. The key outcomes of interest included: adherence rates/proportion meeting target, efficacy, safety/tolerability, non-clinical and economic outcomes. Results: After screening 63 full-text articles and posters, 14 studies were eligible for the meta-analysis. The analysis showed that patients taking STR had improved outcomes over those taking MTR. Patients were significantly more adherent regardless of daily dosing frequency (odds ratio [OR]: 1.96, p<0.001) and were more likely to achieve virological suppression (relative risk [RR]: 1.05, p=0.002). There was a trend toward a lower discontinuation risk in the STR cohort, together with reported higher therapy satisfaction, better symptom control, improved health status, reduced healthcare resource utilization and demonstrated cost-effectiveness compared to MTR. There were no differences in CD4 cell count increase (at 48weeks) or safety outcomes. Conclusions: The findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.

AB - Objectives: To compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. Design: Systematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens. Methods: The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis. Double-blinded studies were excluded due to lack of difference in pill burden between cohorts. The key outcomes of interest included: adherence rates/proportion meeting target, efficacy, safety/tolerability, non-clinical and economic outcomes. Results: After screening 63 full-text articles and posters, 14 studies were eligible for the meta-analysis. The analysis showed that patients taking STR had improved outcomes over those taking MTR. Patients were significantly more adherent regardless of daily dosing frequency (odds ratio [OR]: 1.96, p<0.001) and were more likely to achieve virological suppression (relative risk [RR]: 1.05, p=0.002). There was a trend toward a lower discontinuation risk in the STR cohort, together with reported higher therapy satisfaction, better symptom control, improved health status, reduced healthcare resource utilization and demonstrated cost-effectiveness compared to MTR. There were no differences in CD4 cell count increase (at 48weeks) or safety outcomes. Conclusions: The findings of this study confirm previously reported preliminary findings of the advantages of STR over MTR for HIV treatment in adherence, therapy continuation, viral suppression, tolerability, quality of life improvement, cost-effectiveness and healthcare resource utilization.

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KW - Human immunodeficiency virus

KW - Quality of life

KW - Treatment adherence and compliance

KW - Treatment outcome

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DO - 10.1186/s12981-018-0204-0

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