Tags

Type your tag names separated by a space and hit enter

Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy.
BMJ 2002; 324(7340):757BMJ

Abstract

OBJECTIVE

To assess the evidence for the effectiveness of increasing numbers of drugs in antiretroviral combination therapy.

DESIGN

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.

PARTICIPANTS

Patients with any stage of HIV infection who had not received antiretroviral therapy.

MAIN OUTCOME MEASURES

Changes in disease progression or death (clinical outcomes); CD4 count and plasma viral load (surrogate markers).

SEARCH STRATEGY

Six electronic databases, including Medline, Embase, and the Cochrane Library, searched up to February 2001.

RESULTS

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.

CONCLUSIONS

Evidence from randomised controlled trials supports the use of triple therapy. Research is needed on the effectiveness of quadruple therapies and the relative effectiveness of specific combinations of drugs.

Authors+Show Affiliations

Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT. r.e.jordan@bham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

11923157

Citation

Jordan, Rachel, et al. "Systematic Review and Meta-analysis of Evidence for Increasing Numbers of Drugs in Antiretroviral Combination Therapy." BMJ (Clinical Research Ed.), vol. 324, no. 7340, 2002, p. 757.
Jordan R, Gold L, Cummins C, et al. Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy. BMJ. 2002;324(7340):757.
Jordan, R., Gold, L., Cummins, C., & Hyde, C. (2002). Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy. BMJ (Clinical Research Ed.), 324(7340), p. 757.
Jordan R, et al. Systematic Review and Meta-analysis of Evidence for Increasing Numbers of Drugs in Antiretroviral Combination Therapy. BMJ. 2002 Mar 30;324(7340):757. PubMed PMID: 11923157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy. AU - Jordan,Rachel, AU - Gold,Lisa, AU - Cummins,Carole, AU - Hyde,Chris, PY - 2002/3/30/pubmed PY - 2002/4/17/medline PY - 2002/3/30/entrez SP - 757 EP - 757 JF - BMJ (Clinical research ed.) JO - BMJ VL - 324 IS - 7340 N2 - OBJECTIVE: To assess the evidence for the effectiveness of increasing numbers of drugs in antiretroviral combination therapy. DESIGN: 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. PARTICIPANTS: Patients with any stage of HIV infection who had not received antiretroviral therapy. MAIN OUTCOME MEASURES: Changes in disease progression or death (clinical outcomes); CD4 count and plasma viral load (surrogate markers). SEARCH STRATEGY: Six electronic databases, including Medline, Embase, and the Cochrane Library, searched up to February 2001. RESULTS: 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. CONCLUSIONS: Evidence from randomised controlled trials supports the use of triple therapy. Research is needed on the effectiveness of quadruple therapies and the relative effectiveness of specific combinations of drugs. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/11923157/Systematic_review_and_meta_analysis_of_evidence_for_increasing_numbers_of_drugs_in_antiretroviral_combination_therapy_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=11923157 DB - PRIME DP - Unbound Medicine ER -