Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy

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@article{e9206ff0827440b990710e0b4643aef4,
title = "Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy",
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.",
author = "Rachel Jordan and Lisa Gold and Carole Cummins and Chris Hyde",
year = "2002",
month = mar,
day = "30",
language = "English",
volume = "324",
pages = "757--760",
journal = "British Medical Journal (International edition)",
issn = "0959-8146",
publisher = "BMJ Publishing Group",
number = "7340",

}

RIS

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

Y1 - 2002/3/30

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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0037196929&partnerID=8YFLogxK

M3 - Article

C2 - 11923157

AN - SCOPUS:0037196929

VL - 324

SP - 757

EP - 760

JO - British Medical Journal (International edition)

JF - British Medical Journal (International edition)

SN - 0959-8146

IS - 7340

ER -