Switch studies in virologically suppressed patients

Switch NNRTI to NNRTI
Switch EFV to ETR: Patient's preference
Original article : AIDS. 2011 Jan 2;25(1):57-63 – A Nguyen
Last update : 07/09/2015

Dr Anton Pozniak
Chelsea and Westminster Hospital
London, UK

  • Patients on long-term EFV do not, as a rule, prefer ETR after a switch
  • In patients who have tolerated an EFV regimen for extended periods, switching to an ETR regimen is of limited benefit insofar, as neuropsychiatric side-effects are a concern
  • Patients on ETR, however, had a better lipid profile

Design


Objective

  • Primary Endpoint: patient preference of first or second regimen, by questionnaire at W12
  • Standardized questionnaires: patient anxiety and depression, sleepiness during the day, sleep quality and antiretroviral satisfaction ( HIVTSQc )
  • Plasma drug concentration: D1 and end of both treatment phases

Baseline characteristics and disposition

  • Median duration of EFV exposure: 3.9 years (IQR : 1.9-6.6)

Patient's preference and drug prescription at W12, N


* p < 0.0001 (15/21 : 71% vs 16/17 : 91%)

Anxiety, depression and sleep assessment

  • No significant differences among depression, anxiety, sleepiness or sleep quality between the two study periods

Safety and laboratory parameters

  • Serious adverse events, N = 2, unrelated to study drugs
  • Significantly lower lipid levels in patients on ETR when compared with patients on EFV
    • Total cholesterol (median change : - 0.7 mmol /l; IQR : - 1.1, - 0.2; p < 0.0001)
    • LDL-cholesterol (median change : - 0.6 mmol /l; IQR : - 0.7, - 0.1; p < 0.0001)
    • Triglycerides ( median change : - 0.3 mmol /l ; IQR : - 0.9 , - 0.1; p = 0.0002)

 

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