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Systematic Literature Review and Meta-Analysis of Renal Function in Human Immunodeficiency Virus (HIV)-Infected Patients Treated with Atazanavir (ATV)-Based Regimens.

Cure S, Bianic F, Espinas C, Hardy H, Rosenblatt L, Juday T - PLoS ONE (2015)

Bottom Line: With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89).The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC.With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r.

View Article: PubMed Central - PubMed

Affiliation: Health Economic and Outcomes Research, OptumInsight, Uxbridge, United Kingdom.

ABSTRACT
Some HIV antiretroviral therapies (ART) have been associated with renal toxicities, which become of increasing concern as HIV-infected patients age and develop comorbidities. The objective of this study was to evaluate the relative impact of atazanavir (ATV)-based regimens on the renal function of adult patients with HIV. We conducted a systematic literature review by searching PubMed, EMBASE, Cochrane library, and the CRD from 2000 until March 2013. Major HIV-related conferences occurring in the past two years were also searched. All randomized clinical trials and large cohort studies assessing renal function in treatment-naïve and/or treatment-experienced HIV patients on ATV-based regimens were included. Fixed-effect mixed-treatment network analyses were carried out on the most frequently reported renal outcomes. 23 studies met the inclusion criteria, and change in estimated glomerular filtration rate (eGFR) from baseline to 48 weeks was identified as the main outcome. Two networks including, respectively, six studies (using the Cockcroft-Gault method) and four studies (using MDRD and CKD-EPI) were analysed. With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89). The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC. With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r. The effect of ATV-based regimens on renal function at 48 weeks appears similar to other ART regimens and appears to be modest regardless of boosting agent or backbone, although TDF containing backbones consistently leads to greater decline in eGFR.

No MeSH data available.


Related in: MedlinePlus

Results from the MTC: Difference in mean change in eGFR from baseline at 48 weeks (using CG method).CG: Cockcroft–Gault; eGFR: estimated Glomerular Filtration Rate; MTC: Mixed-Treatment Comparison.
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pone.0124666.g004: Results from the MTC: Difference in mean change in eGFR from baseline at 48 weeks (using CG method).CG: Cockcroft–Gault; eGFR: estimated Glomerular Filtration Rate; MTC: Mixed-Treatment Comparison.

Mentions: The estimated difference in the mean change in eGFR from baseline for each comparator treatment and their associated 95% credible intervals (credible interval in Bayesian statistics are analogous to confidence interval in frequentist statistics) relative to the reference treatment ATV/r + TDF/FTC is shown in Fig 4 and Table 5. A difference in the mean change in eGFR from baseline less than 0 indicates that one treatment had a higher decrease or lower increase in eGFR in comparison to the reference treatment.


Systematic Literature Review and Meta-Analysis of Renal Function in Human Immunodeficiency Virus (HIV)-Infected Patients Treated with Atazanavir (ATV)-Based Regimens.

Cure S, Bianic F, Espinas C, Hardy H, Rosenblatt L, Juday T - PLoS ONE (2015)

Results from the MTC: Difference in mean change in eGFR from baseline at 48 weeks (using CG method).CG: Cockcroft–Gault; eGFR: estimated Glomerular Filtration Rate; MTC: Mixed-Treatment Comparison.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4418798&req=5

pone.0124666.g004: Results from the MTC: Difference in mean change in eGFR from baseline at 48 weeks (using CG method).CG: Cockcroft–Gault; eGFR: estimated Glomerular Filtration Rate; MTC: Mixed-Treatment Comparison.
Mentions: The estimated difference in the mean change in eGFR from baseline for each comparator treatment and their associated 95% credible intervals (credible interval in Bayesian statistics are analogous to confidence interval in frequentist statistics) relative to the reference treatment ATV/r + TDF/FTC is shown in Fig 4 and Table 5. A difference in the mean change in eGFR from baseline less than 0 indicates that one treatment had a higher decrease or lower increase in eGFR in comparison to the reference treatment.

Bottom Line: With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89).The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC.With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r.

View Article: PubMed Central - PubMed

Affiliation: Health Economic and Outcomes Research, OptumInsight, Uxbridge, United Kingdom.

ABSTRACT
Some HIV antiretroviral therapies (ART) have been associated with renal toxicities, which become of increasing concern as HIV-infected patients age and develop comorbidities. The objective of this study was to evaluate the relative impact of atazanavir (ATV)-based regimens on the renal function of adult patients with HIV. We conducted a systematic literature review by searching PubMed, EMBASE, Cochrane library, and the CRD from 2000 until March 2013. Major HIV-related conferences occurring in the past two years were also searched. All randomized clinical trials and large cohort studies assessing renal function in treatment-naïve and/or treatment-experienced HIV patients on ATV-based regimens were included. Fixed-effect mixed-treatment network analyses were carried out on the most frequently reported renal outcomes. 23 studies met the inclusion criteria, and change in estimated glomerular filtration rate (eGFR) from baseline to 48 weeks was identified as the main outcome. Two networks including, respectively, six studies (using the Cockcroft-Gault method) and four studies (using MDRD and CKD-EPI) were analysed. With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89). The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC. With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r. The effect of ATV-based regimens on renal function at 48 weeks appears similar to other ART regimens and appears to be modest regardless of boosting agent or backbone, although TDF containing backbones consistently leads to greater decline in eGFR.

No MeSH data available.


Related in: MedlinePlus