Review of the impact of NNRTI-based HIV treatment regimens on patient-reported disease burden

Abstract

While the burden of HIV disease is well documented, the value of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy regimens in reducing patient burden is not well understood. The purpose of this study was to examine patient-reported health among those receiving NNRTI-based regimens to understand their incremental value in reducing the burden of HIV. We conducted a structured literature review using PubMed to identify NNRTI trials utilizing validated patient-reported outcome (PRO) instruments during 2005–2011. The search strategy included a PubMed search to identify relevant studies based on disease, instrument, PRO, and NNRTI medication terms; and a manual search of bibliographies of identified papers. Data abstracted from each study included study type, treatment regimen(s), and PRO results. Of 11 trials identified, 8 (73%) reported significance of changes in a PRO over time and 10 (91%) reported significance of PRO changes between groups. Several domains were assessed, with significant findings (between or within groups) observed in: physical health/well-being (n = 5), emotional status/well-being (n = 2), symptoms (n = 2), anxiety (n = 2), gastrointestinal upset (n = 2), psychological health (n = 1), functional and global well-being (n = 1), fatigue/energy (n = 1), depression (n = 1), change in body appearance (n = 1), pain (n = 1), headache (n = 1), bad dreams/nightmares (n = 1), problems having sex (n = 1), and general health perception (n = 1). In conclusion, NNRTIs have been observed most frequently to improve patient-reported physical health and well-being. Treatments are needed that can also reduce patient burden in areas of emotional well-being, cognitive functioning, and overall symptom profile.

Keywords:

• HIV
• patient-reported outcome (PRO)
• instrument
• burden
• NNRTI

Acknowledgments

Kristin A. Hanson and Chris L. Pashos are employees of UBC: An Express Scripts Company and Gale Harding is an employee of Evidera, both of which received funding for this research from Pfizer. Seema Haider and Margaret Tawadrous are employees of and have equity ownership in Pfizer. Alexandra Khachatryan was an employee of Pfizer at the time the study was conducted. Kit N. Simpson and Albert W. Wu received funding for this research from Pfizer.

Supplemental Material

All Supplemental Material is available alongside this article on www.tandfonline.com – go to http://dx.doi.org/10.1080/09540121.2013.841825