Clinical Report: Single- and multi-tablet HIV regimens go head-to-head

Overview

A study found that contemporary once-daily single-tablet and multi-tablet HIV regimens had similar rates of viral suppression among Medicaid enrollees in Washington state.

Background

The choice between single-tablet regimens (STRs) and multi-tablet regimens (MTRs) in HIV treatment is important due to the potential impact on adherence and health outcomes. STRs have been favored for their convenience, but their higher costs raise questions about their clinical advantages. Understanding the effectiveness of these regimens is crucial for optimizing HIV care.

Data Highlights

Key Findings

• Overall viral suppression was 90.4% among Medicaid enrollees with HIV.
• Viral suppression rates were similar between STRs (91.6%) and MTRs (88.9%) after adjustment.
• Housing status significantly impacted viral suppression, with lower rates in individuals experiencing unstable housing.
• In those with stable housing, suppression rates were 94.1% for STRs and 91.3% for MTRs, with no significant difference.
• Bictegravir/emtricitabine/tenofovir alafenamide is approximately 77% more expensive than some dolutegravir-based MTRs.

Clinical Implications

Clinicians should consider the clinical effectiveness and cost of HIV treatment regimens when making prescribing decisions.

Conclusion

The study indicates that there may not be a meaningful difference in efficacy between single-tablet and multi-tablet regimens for most patients.

Related Resources & Content

1. Golden MR, et al., Open Forum Infectious Diseases, 2023 -- Contemporary Single and Multi-Tablet HIV Treatment Regimens Are Associated With Similar Levels of Viral Suppression
2. MDSpire News, 2023 -- Two-Drug HIV Regimen Gains FDA Approval
3. MDSpire News, 2023 -- Weekly HIV Therapy Meets Primary Endpoint
4. MDSpire News, 2023 -- Weekly HIV Regimen Meets Phase 3 Goal
5. Adult and Adolescent Antiretroviral Guidelines - Recommendations Only
6. The Journal of Infectious Diseases — In-depth Analysis of the HIV Reservoir Confirms Effectiveness and Safety of Dolutegravir/Lamivudine in a Phase 4 Randomized Controlled Switch Trial (RUMBA)
7. Adult and Adolescent Antiretroviral Guidelines - Recommendations Only
8. Contemporary Single and Multi-Tablet HIV Treatment Regimens Are Associated With Similar Levels of Viral Suppression | Open Forum Infectious Diseases | Oxford Academic
9. Adherence to the Continuum of Care | NIH