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The dose of the non-nucleoside
reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva or Stocrin) can be
cut by a third without compromising patient outcomes, results of the ENCORE 1
study show. Cost savings associated with this dose reduction could increase
access to HIV therapy in resource-limited settings.
Efavirenz is a mainstay of
first-line HIV therapy around the world.
The standard daily dose is 600mg.
However, some observational data have suggested that this can be safely reduced
to 400mg.
Researchers wanted to see if this
was the case. They designed a randomized, double-blind trial to see if
combinations based on a 400mg dose of efavirenz were non-inferior to
combinations including the standard 600mg daily dose.
A total of 636 people in 13
countries were recruited to the study.
Efavirenz was taken in combination
with Truvada (FTC/tenofovir).
After 48 weeks, 94% of participants
taking the 400mg dose and 92% of those treated with the standard dose had an
undetectable viral load (defined as below 200 copies/ml). Restricting analysis
to people with a high baseline viral load confirmed the virological efficacy of
the 400mg dose compared to the 600mg dose (93 vs 91% undetectable).
Participants taking the 400mg dose
had fewer side-effects, especially those affecting the central nervous system.
The researchers conclude that the
400mg dose had demonstrated its non-inferiority and that the use of the lower
dose could cut the costs associated with the drug by one-third.
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus.
To learn more about The Friends of
AIDS Foundation, please visit: http://www.friendsofaids.org.
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