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Meta-Analysis of Studies Comparing Single and Multi-Tablet Fixed Dose Combination HIV Treatment Regimens.

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Fixed-dose single tablet regimens (STRs) improve adherence and viral load suppression in HIV management compared to multiple tablet regimens (MTRs). STRs also reduce healthcare costs and resource use, aiding decision-making in HIV care.

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Area of Science:

  • Infectious Diseases
  • Pharmacoeconomics
  • Public Health

Background:

  • Human immunodeficiency virus (HIV) management requires effective treatment strategies.
  • Fixed-dose combination therapies, including single-tablet regimens (STRs) and multiple-tablet regimens (MTRs), are crucial for patient adherence and clinical outcomes.
  • Optimal selection between STRs and MTRs necessitates a comprehensive review of comparative data.

Purpose of the Study:

  • To conduct a meta-analysis comparing patient adherence, clinical outcomes, and cost-effectiveness of STRs versus MTRs for HIV management.
  • To provide evidence-based information for healthcare providers and policymakers involved in HIV care decisions.

Main Methods:

  • A systematic literature search was performed on Embase, PubMed, and ClinicalTrials.Gov for studies published between 2005 and 2014.
  • Two independent researchers screened articles for eligibility, with 35 articles selected for qualitative synthesis and 9 for quantitative meta-analysis.
  • Random-effects meta-analysis was used to compare adherence, efficacy (viral load suppression, CD4 count), safety (adverse events), tolerability, healthcare resource utilization (HRU), and costs.

Main Results:

  • Patients on STRs demonstrated significantly higher adherence compared to those on MTRs (OR: 2.37).
  • STRs were associated with improved viral load suppression (RR: 1.09) and fewer grade 3-4 laboratory abnormalities (RR: 0.68).
  • Tolerability, safety, and mortality were comparable; however, STRs showed reduced HRU and costs.

Conclusions:

  • Fixed-dose single-tablet regimens (STRs) offer superior adherence and viral load suppression in HIV treatment compared to multiple-tablet regimens (MTRs).
  • STRs are associated with favorable healthcare resource utilization and cost-effectiveness.
  • These findings support the use of STRs for optimal HIV disease management, particularly in resource-limited settings.