Important note: Information in this article was accurate in February 2009. The state of the art may have changed since the publication date.
AIDSWEEKLY Plus; Monday, February 2, 2009
Staff Medical Writers
NewsRx -- "Preliminary data suggest that a once-daily combination of lamivudine, didanosine and efavirenz is an effective alternative regimen for antiretroviral-naive HIV-1-infected patients. However, data from randomized trials comparing this combination versus standard first-line regimens are not available yet," researchers in Barcelona, Spain report (see also HIV/AIDS).
"In an observational study, we analyse the efficacy and tolerability of didanosine plus lamivudine and efavirenz versus zidovudine plus lamivudine and efavirenz in a cohort of therapy naive patients. We performed an observational study on prospectively collected data from patients participating in a multicentre Spanish treatment-naive cohort (VACH cohort). Efficacy was assessed comparing time to therapeutic failure and CD4 cell recovery. Safety was analysed comparing the proportion of patients who discontinued therapy for toxicity or any other reason. Overall, 219 patients treated with once-daily didanosine/lamivudine/efavirenz and 409 patients receiving twice-daily zidovudine/lamivudine (Combivir((R))) plus efavirenz were evaluated. By intent-to treat analysis (non-completers and therapeutic change = failure), time to treatment failure was similar in both groups of treatment: 40.0 months (95% CI 23.3-56.8 months) among patients on didanosine/lamivudine/efavirenz and 33.3 months (95% CI 25.6-41.1 months) in patients treated with zidovudine/lamivudine/efavirenz (P = 0.253). The risk of failure due to treatment change was almost double among patients treated with zidovudine/lamivudine/efavirenz compared with those who received didanosine/lamivudine/efavirenz. Our data suggest that didanosine/lamivudine/efavirenz is a combination with an efficacy comparable to zidovudine/lamivudine/efavirenz as first-line therapy for HIV infection," wrote M. Crespo and colleagues, Vall d'Hebron University.
The researchers concluded: "The risk of treatment change was significantly higher among patients treated with zidovudine/lamivudine/efavirenz than in those starting therapy with didanosine/lamivudine/efavirenz."
Crespo and colleagues published their study in the Journal of Antimicrobial Chemotherapy (Effectiveness and safety of didanosine, lamivudine and efavirenz versus zidovudine, lamivudine and efavirenz for the initial treatment of HIV-infected patients from the Spanish VACH cohort. J Antimicrob Chemother. 2009 Jan;63(1):189-96.
For additional information, contact E. Ribera, Vall d'Hebron University Hospital, Division Infectious Disease, Paseo Vall Hebron 119-129, Barcelona 08035, Spain.
Publisher contact information for the Journal of Antimicrobial Chemotherapy is: Oxford University Press, Great Clarendon St., Oxford OX2 6DP, England.
Keywords: Spain, Barcelona, HIV/AIDS, AIDS, Acquired Immunodeficiency Syndrome, Antimicrobials, Antivirals, Chemotherapy, Clinical Trial Research, Didanosine, Drug Therapy, Drugs, Efavirenz, HIV, Human Immunodeficiency Virus, Lamivudine, Nucleoside Reverse Transcriptase Inhibitor, Pharmaceuticals, Treatment, Virology, Zidovudine, Vall d'Hebron University.
This article was prepared by AIDS Weekly editors from staff and other reports.
Ref: Crespo M, Ribera E, et al., “Effectiveness and safety of didanosine, lamivudine and efavirenz versus zidovudine, lamivudine and efavirenz for the initial treatment of HIV-infected patients from the Spanish VACH cohort”, J Antimicrob Chemother. 2009 Jan;63(1):189-96.
2009-02-02
AW090203
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