HIV drug regimen better with efavirenz than nelfinavir
Efavirenz is better than nelfinavir for treating HIV when part of a triple drug regimen using didanosine and stavudine as the initial nucleoside analogue reverse transcriptase inhibitor (NRTI) backbone, according to data published in The
Lancet last week (2006; 368:287).
The study, known as the INITIO trial, compared three treatment strategies
for initiating antiretroviral therapy, each with the same NRTI backbone.
A total of 911 patients received the NRTI backbone plus either efavirenz
or nelfinavir, or both, for three years. Investigators were allowed to
substitute one drug for another from the same class if intolerance occurred.
More patients in the efavirenz group (74 per cent) had a viral load of
less than 50 copies per ml than in the nelfinavir group and the efavirenz/nelfinavir
group (both 62 per cent; P=0.004). Median time to reach this viral load
was shorter in the efavirenz group. The median change from baseline in
CD4 cell count over time was not significantly different between the
three groups, say the researchers. They add that, at three years, the
number of deaths and new AIDS events were similar in all groups.
At three years, only 20 per cent of patients in the efavirenz group had
started a third class of drug compared with 40 per cent in the nelfinavir
group. |
The
Pharmaceutical Journal
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