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 Conference
"Clinical NRTI Update: Support for your Backbone Options"
Graeme Moyle (biography)
English - 2005-04-26 - 61 minutes
(42 slides)
(24 slides)

Summary :
Zidovudine has been the common drug of choice in an antiretroviral backbone regimen. This presentation delivers extensive evidence to support alternative backbone options in antiretroviral therapy. Particularly, Prof. Moyle compares the efficacy of abacavir and tenofovir to zidovudine or stavudine looking specifically at viral load, CD4 recovery, drug interactions, resistance profiles, and adverse effects. To support these comparisons, Prof. Moyle discusses key studies in detail. These include the ABCDE, GS903, 934, CNA30024, ESS30008, and the RAVE study.

In addition to efficacy, other important aspects to consider in a backbone are the drug interactions and adverse effects. Prof Moyle reviews in detail the adverse effects observed in the ABCDE, 903, MITOX, and RAVE study. Among the effects reported are lipodystrophy, metabolism, hypersensitivity, bone mass density, and renal dysfunction.

Finally, resistance profiles and their consequences need to be considered in a regimen. Phenotypic susceptibility to resistance mutations and the alternative treatment options to circumvent this susceptibility are outlined in this presentation.

Overall, Prof. Moyle provides a thorough and evidence-based presentation supporting abacavir and/or tenofovir as alternative backbone options in treatment naīve patients.

Copyright Š 2005 E-MedHosting.com Inc.

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- Efficacy of abacavir and tenofovir in an antiretroviral drug regimen;
- Drug interactions, adverse effects, and resistance profiles of these backbone options.

Bibliographic references :
Moyle, Graeme J MD, MBBS; DeJesus, Edwin MD; Cahn, Pedro MD; Castillo, Steve A MSc; Zhao, Henry PhD; Gordon, David N MB, ChB; Craig, Charles PhD; Scott, Trevor R PhD; for the Ziagen Once-Daily in Antiretroviral Combination Therapy (CNA30021) Study TeamAbacavir Once or Twice Daily Combined With Once-Daily Lamivudine and Efavirenz for the Treatment of Antiretroviral-Naive HIV-Infected Adults: Results of the Ziagen Once Daily in Antiretroviral Combination Study.JAIDS Journal of Acquired Immune Deficiency Syndromes. 38(4):417-425, April 1, 2005.

Michael D. Miller, Nicolas Margot, Biao Lu, Lijie Zhong, Shan-Shan Chen, Andrew Cheng, and Michael Wulfsohn Genotypic and Phenotypic Predictors of the Magnitude of Response to Tenofovir Disoproxil Fumarate Treatment in Antiretroviral-Experienced PatientsThe Journal of Infectious Diseases 2004;189:837-846

Shlay, Judith C MD, MSPH; Visnegarwala, Fehmida MD; Bartsch, Glenn PhD; Wang, Jack MS; Peng, Grace MS; El-Sadr, Wafaa M MD, MPH; Gibert, Cynthia MD; Kotler, Donald MD; Grunfeld, Carl MD, PhD; Raghavan, Subhasree PhD; for the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA)Body Composition and Metabolic Changes in Antiretroviral-Naive Patients Randomized to Didanosine and Stavudine vs. Abacavir and Lamivudine. JAIDS 38(2):147-155, February 1, 2005.

Martin, Allison; Smith, Don E; Carr, Andrew; Ringland, Clare; Amin, Janaki; Emery, Sean; Hoy, Jennifer; Workman, Cassy; Doong, Nicholas; Freund, Judith; Cooper, David A; for the Mitochondrial Toxicity (MITOX) Study GroupReversibility of lipoatrophy in HIV-infected patients 2 years after switching from a thymidine analogue to abacavir: the MITOX Extension Study.AIDS. 18(7):1029-1036, April 30, 2004.

Seth Hetherington, Sue McGuirk, Gwendolyn Powell, Amy Cutrell, Odin Naderer, Bill Spreen, Steve Lafon, Gill Pearce and Helen SteelHypersensitivity reactions during therapy with the nucleoside reverse transcriptase inhibitor abacavirClinical Therapeutics, Volume 23, Issue 10, October 2001, Pages 1603-1614

   


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