Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy

BMJ : British Medical Journal
Rachel JordanChris Hyde

Abstract

To assess the evidence for the effectiveness of increasing numbers of drugs in antiretroviral combination therapy. Systematic review, meta-analysis, and meta-regression of fully reported randomised controlled trials. All studies included compared quadruple versus triple therapy, triple versus double therapy, double versus monotherapy, or monotherapy versus placebo or no treatment. Patients with any stage of HIV infection who had not received antiretroviral therapy. Changes in disease progression or death (clinical outcomes); CD4 count and plasma viral load (surrogate markers). Six electronic databases, including Medline, Embase, and the Cochrane Library, searched up to February 2001. 54 randomised controlled trials, most of good quality, with 66 comparison groups were included in the analysis. For both the clinical outcomes and surrogate markers, combinations with up to and including three (triple therapy) were progressively and significantly more effective. The odds ratio for disease progression or death for triple therapy compared with double therapy was 0.6 (95% confidence interval 0.5 to 0.8). Heterogeneity in effect sizes was present in many outcomes but was largely related to the drugs used and trial quality. Evidence fro...Continue Reading

References

Mar 1, 1985·Progress in Cardiovascular Diseases·S YusufP Sleight
Aug 17, 1995·The New England Journal of Medicine·S Kinloch-De LoësL Mathiesen
Jun 1, 1995·Annals of Internal Medicine·J P IoannidisH S Sacks
Nov 19, 1994·BMJ : British Medical Journal·S G Thompson
May 1, 1993·Journal of Acquired Immune Deficiency Syndromes : JAIDS·A W WuJ A McCutchan
Jun 15, 1993·Proceedings of the National Academy of Sciences of the United States of America·R T DaveyS E Haneiwich
Apr 15, 1996·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·S MaussH Jablonowski
Jul 10, 1996·JAMA : the Journal of the American Medical Association·C C CarpenterP A Volberding
Jan 24, 1998·Lancet·J LauC H Schmid
Feb 24, 1998·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·S EversI W Husstedt
Feb 3, 1999·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·M FloridiaS Vella
Apr 20, 1999·AIDS·UNKNOWN Delta Coordinating Committee, UNKNOWN Delta Virology Committee

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Citations

Jul 2, 2004·The New England Journal of Medicine·Wafaie W FawziDavid J Hunter
May 25, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elena LosinaRochelle P Walensky
Feb 1, 2007·AIDS Patient Care and STDs·Phebe K LamKathryn Wright
Feb 15, 2012·Antimicrobial Agents and Chemotherapy·Sarah HarmanRobin J Shattock
Mar 30, 2002·BMJ : British Medical Journal·Charles Carpenter
Feb 8, 2003·BMJ : British Medical Journal·Joanne L AtkinsPeter E M Butler
Apr 29, 2014·Complementary Therapies in Clinical Practice·K A OshikoyaI O Senbanjo
Jan 9, 2010·AIDS and Behavior·Pride Chigwedere, M Essex
Dec 17, 2008·Expert Review of Gastroenterology & Hepatology·Suzanne NorrisDiarmaid Houlihan
Apr 28, 2009·Infectious Disease Clinics of North America·Mical Paul, Leonard Leibovici
Apr 28, 2009·Infectious Disease Clinics of North America·Paschalis I VergidisDavidson H Hamer
Jan 7, 2011·Journal of Clinical Pharmacology·Zhong WangYongyan Wang
Jun 23, 2015·Indian Journal of Dental Research : Official Publication of Indian Society for Dental Research·Nathalia Ferraz OliscoviczIvete Pomarico Ribeiro Souza
Jul 7, 2011·International Journal of STD & AIDS·J KumwendaT E Taha
Mar 4, 2006·Expert Review of Molecular Diagnostics·Frank CordesJoachim Selbig
May 25, 2005·Fundamental & Clinical Pharmacology·Karl BrendelUNKNOWN Cophar 1-ANRS 102 Trial Group
Dec 21, 2004·The Journal of Antimicrobial Chemotherapy·Chloe OrkinBrian Gazzard
Apr 14, 2019·Lifetime Data Analysis·Layla ParastTianxi Cai
Mar 29, 2003·Drugs·Risto S Cvetkovic, Karen L Goa

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