Simplification Strategies to Reduce Antiretroviral drug Exposure: Progress and Prospects
Simplification Strategies to Reduce Antiretroviral drug Exposure: Progress and Prospects
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减少抗逆转录病毒药物暴露的简化策略：进展与前景
DOI：
10.1177/135965350901400109
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发表时间：
2009
影响因子：
1.2
通讯作者：
S. Swindells
中科院分区：
文献类型：
--
作者：
J. McKinnon;J. Mellors;S. Swindells
目前美国HIV-1感染初始治疗指南推荐每日终身联合使用三种抗逆转录病毒药物，包括两种核苷类逆转录酶抑制剂和一种非核苷类逆转录酶抑制剂或一种蛋白酶抑制剂。尽管这种方法在降低HIV-1感染的发病率和死亡率方面取得了成功，但人们仍然担心慢性药物暴露的不良事件、每天坚持服药的要求、HIV-1耐药性的风险和高昂的治疗费用。每日一次共配制和给药的抗逆转录病毒药物的可用性减轻了药丸负担，简化了给药计划，但没有降低药物暴露或成本。这些限制刺激了对药物节约策略的研究，包括间歇治疗和简化维持方案。随机临床试验表明，与连续治疗相比，间歇性治疗的死亡率更高，导致对该策略的排斥。单纯使用利托那韦增强蛋白酶抑制剂的简化维持治疗的初步研究显示出更大的希望，尽管仍存在担忧。本文综述了简化抗逆转录病毒治疗的进展，最近的临床试验结果和对未来的展望。
Current US guidelines for initial therapy of HIV type-1 (HIV-1) infection recommend daily, lifelong treatment with a combination of three antiretroviral drugs consisting of two nucleoside analogue reverse transcriptase inhibitors and a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor. Although this approach has been successful in reducing morbidity and mortality from HIV-1 infection, concerns remain about adverse events from chronic drug exposure, the requirement for daily medication adherence, the risk of HIV-1 drug resistance and high treatment costs. The availability of antiretrovirals that are coformulated and dosed once daily have reduced pill burden and have simplified dosing schedules, but have not lowered drug exposure or cost. These limitations have stimulated research into drug-sparing strategies including intermittent therapy and simplified maintenance regimens. Randomized clinical trials have shown greater mortality with intermittent therapy compared with continuous therapy leading to rejection of this strategy. Pilot studies of simplified maintenance therapy with a ritonavir-boosted protease inhibitor alone have shown more promise, although concerns remain. This article reviews progress in the simplification of antiretroviral therapy, recent clinical trial results and prospects for the future.
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治疗方案简化为阿扎那韦-利托那韦单独作为持续病毒学抑制后的维持性抗逆转录病毒治疗。
DOI：
10.1001/jama.296.7.806
发表时间：
2006
期刊：
JAMA
影响因子：
--
作者：
Swindells,Susan;DiRienzo,AGregory;Wilkin,Timothy;Fletcher,CourtneyV;Margolis,DavidM;Thal,GaryD;Godfrey,Catherine;Bastow,Barbara;Ray,MGraham;Wang,Hongying;Coombs,RobertW;McKinnon,John;Mellors,JohnW;AIDSClinicalTrialsGrou
通讯作者：
AIDSClinicalTrialsGrou
通用齐多夫定拉米夫定（Cipla，Duovir）和葛兰素史克品牌（Combivir）片剂的比较。
DOI：
10.1097/00126334-200404150-00012
发表时间：
2004
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Henry,Keith;Brundage,Richard;Weller,Dennis;Akinsete,Omobosola;Shet,Anita
通讯作者：
Shet,Anita
HIV 治疗简化的潜在风险和益处：拟议临床试验的模拟模型。
DOI：
10.1086/521933
发表时间：
2007
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Schackman,BruceR;Scott,CallieA;Sax,PaulE;Losina,Elena;Wilkin,TimothyJ;McKinnon,JohnE;Swindells,Susan;Weinstein,MiltonC;Freedberg,KennethA
通讯作者：
Freedberg,KennethA
影响因子：
158.5
作者：
Robbins, GK;De Gruttola, V;Doolan, A
通讯作者：
Doolan, A