AIDSWEEKLY Plus; Monday, August 1, 2005
Staff Medical Writers

"Adherence to antiretroviral therapy is critical to treatment outcomes. Adherence studies in other therapeutic areas of medicine suggest that once-daily regimens support improved adherence when compared to twice-daily therapy.

"An expansion in the range of once-daily antiretrovirals is making once-daily therapy possible for persons with HfV infection," researchers in England report.

"A 24-week randomized open-label simplification study of twice-daily regimens based on stavudine immediate release or zidovudine to an all once-daily regimen based on the stavudine prolonged-release capsule (PRC), in persons with complete virological suppression on regimens also including efavirenz and lamivudine, was carried out.

"Subjects were assessed for adherence [using the Medication Event Monitoring System) (MEMS) cap; Aardex Corporation, Union City, CA, USA], quality of life, tolerability and efficacy," wrote S.D. Portsmouth and coworkers at Chelsea & Westminster Hospital in London.

"Forty-three patients were randomly assigned: 21 remained on their original regimen and 22 switched to once-daily therapy with stavudine PRC," continued the authors.

"Although high levels of adherence and good quality of life were present at study enrolment," scientists said, "adherence declined to a significantly lesser extent at week 24 in the group that switched to once-daily therapy. Efficacy was maintained in both groups and there were no differences in tolerability or toxicity."

"Subjects switching from twice-daily therapy to once-daily therapy demonstrate less of a decline in adherence over 24 weeks. A once-daily regimen including stavudine PRC is as effective and tolerable as a regimen containing the twice-daily formulation," concluded Portsmouth.

Portsmouth and colleagues published their study in HIV Medicine (Better maintained adherence on switching from twice-daily to once-daily therapy for HIV: a 24-week randomized trial of treatment simplification using stavudine prolonged-release capsules. HIV Med. 2005 May;6(3):185-90.

For additional information, contact G.J. Moyle, Chelsea & Westminster Hospital, Dept. HIV Med, 369 Fulham Rd., London SW10 9NH, England.

Publisher contact information for the journal HIV Medicine is: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DG, Oxon, England.

Keywords: London, England, HIV/AIDS, Drug Adherence, Stavudine, Once-Daily Dosing, Drug Efficacy.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Portsmouth SD, Osorio J, McCormick K, et al. Better maintained adherence on switching from twice-daily to once-daily therapy for HIV: a 24-week randomized trial of treatment simplification using stavudine prolonged-release capsules., HIV Med. 2005 May;6(3):185-90.

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