Single-tablet regimens in HIV: does it really make a difference?

Abstract

Objectives:

Review of the available data on the currently available single-tablet regimens (STRs), from the analysis of efficacy and safety to the key points of value in terms of adherence, quality of life and pharmacoeconomic evaluation.

Methods:

For this narrative review, literature searches have been performed in PubMed, IndexRevMed and Cochrane, using the search terms HIV, single-tablet, one-pill, single dose, fixed-dose, and STR. These have been reviewed and complemented with the most recent publications of interest.

Results:

Fixed-dose combinations are a significant advance in antiretroviral treatment simplification, contributing to an increase in compliance with complex chronic therapies, thus improving patients’ quality of life. Reducing the number of pills and daily doses is associated with higher adherence and better quality of life. As a fixed-dose combination tablet given once daily, EFV/FTC/TDF was the first available STR combining efficacy, tolerability and convenience, with the simplest dosing schedule and smallest numbers of pills of any ART combination therapy. The RPV/FTC/TDF is a next-generation NNRTI-based STR, a once daily complete ART regimen for the treatment of HIV-1 infection. Recently the combination of EVG/COBI/FTC/TDF was also approved by the European Commission, and is the first integrase inhibitor-based STR. Receiving antiretroviral therapy as once daily STR is associated with both clinical and economic benefits, which confirms previous research.

Conclusions:

The associated benefits of STRs provide a valid strategy for the treatment of HIV-infected patients.

Key words::

• Fixed-dose
• HIV
• Single-tablet
• STR

Transparency

Declaration of funding

This work was supported by Gilead Sciences.

Declaration of financial/other relationships

I.A. discloses that she has served as a consultant for Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Janssen-Cilag, Gilead Sciences, Merck Sharp & Dohme and ViiV Healthcare. A.H. discloses that she has served as a consultant for Bristol-Myers Squibb, Janssen-Cilag, Gilead Sciences, ViiV Healthcare and Merck Sharp and Dohme. M.S. discloses that she has served as a consultant for Janssen-Cilag.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

This work was supported by Gilead Sciences and Eurotrials.