Document Detail


Tenofovir: new indication. For first-line antiretroviral therapy: wait and see.
MedLine Citation:
PMID:  15499699     Owner:  HSR     Status:  MEDLINE    
Abstract/OtherAbstract:
(1) First-line antiretroviral combinations generally include, in addition to a protease inhibitor or a non nucleoside reverse transcriptase inhibitor, two nucleoside reverse transcriptase inhibitors, namely zidovudine + didanosine, stavudine + lamivudine, or zidovudine + lamivudine. (2) Tenofovir disoproxil (referred to simply as tenofovir below) is a nucleotide HIV reverse transcriptase inhibitor. Previously recommended for second-line treatment in case of virological failure, it is now approved for first-line therapy in adults. (3) This licence extension is based on a double-blind trial comparing tenofovir + lamivudine + efavirenz with stavudine + lamivudine + efavirenz in 602 patients. After 96 weeks, three-quarters of patients had undetectable viral load (<50 copies/ml), and there was no statistically significant difference among the groups. (4) The number of serious adverse effects was similar in the two groups. Relative to the stavudine combinations, there were fewer reports of lipodystrophy (1% versus 12%), fewer peripheral neuropathies (3% versus 10%) and fewer prescriptions of lipid-lowering therapy (2% versus 10%) among patients taking tenofovir. Tenofovir seemed to have a worse effect on renal function and bone metabolism, however. (5) Tenofovir is taken only once a day, but so are didanosine and lamivudine. (6) In practice, there is not yet enough evidence to support the routine use of tenofovir in first-line antiretroviral combinations. Tenofovir is, however, an interesting alternative when stavudine is poorly tolerated.
Authors:
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Prescrire international     Volume:  13     ISSN:  1167-7422     ISO Abbreviation:  Prescrire Int     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-22     Completed Date:  2004-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9439295     Medline TA:  Prescrire Int     Country:  France    
Other Details:
Languages:  eng     Pagination:  180-2     Citation Subset:  T    
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / drug therapy*
Anti-HIV Agents / administration & dosage,  adverse effects,  therapeutic use
Antiretroviral Therapy, Highly Active* / methods
Controlled Clinical Trials as Topic
Didanosine / administration & dosage,  adverse effects,  therapeutic use
Drug Therapy, Combination
HIV Infections / drug therapy*
HIV-1 / drug effects
Humans
Lamivudine / administration & dosage,  adverse effects,  therapeutic use
Reverse Transcriptase Inhibitors / administration & dosage,  therapeutic use
Stavudine / administration & dosage,  adverse effects,  therapeutic use
Treatment Outcome
Zidovudine / administration & dosage,  adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Reverse Transcriptase Inhibitors; 134678-17-4/Lamivudine; 30516-87-1/Zidovudine; 3056-17-5/Stavudine; 69655-05-6/Didanosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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