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Strength in Amalgamation: Newer Combination Agents for HIV and Implications for Practice
Christopher McCoy1, Melissa Badowski2, Elizabeth Sherman3
1Department of Pharmacy, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Pharmacotherapy
|November 7, 2017
Summary
Newer single-tablet regimens (STRs) for HIV treatment improve adherence and reduce side effects. These fixed-dose combination pills offer better clinical outcomes for patients on antiretroviral therapy (ART).
Area of Science:
- Infectious Diseases
- Pharmacology
- Virology
Background:
- Antiretroviral therapy (ART) for HIV has evolved significantly over 30 years.
- Numerous single-tablet regimens (STRs) and fixed-dose combination (FDC) tablets are now available.
- These advancements offer improved patient options and treatment outcomes.
Purpose of the Study:
- To review the clinical efficacy and safety of newer coformulated ART agents.
- To highlight comparative adverse events and drug-drug interaction potential.
- To discuss the implications of these regimens on treatment adherence.
Main Methods:
- Review of clinical efficacy and safety data for coformulated ART agents.
- Analysis of comparative adverse events and drug-drug interactions.
- Assessment of clinical implications for patient adherence.
Main Results:
- Newer STRs, particularly integrase strand transfer inhibitor (INSTI)-based regimens, are preferred for initiating HIV treatment.
- These regimens demonstrate faster virologic suppression and reduced resistance development compared to older drug classes.
- Novel components like cobicistat (COBI) and tenofovir alafenamide (TAF) contribute to improved tolerability and simplified regimens.
Conclusions:
- Modern ART simplifies treatment, enhancing patient adherence and clinical outcomes.
- Newer coformulated agents offer improved safety profiles, including better renal and bone tolerability.
- Ongoing research explores further simplification with dual ART therapies.
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