Switching from twice‐daily abacavir and lamivudine to the once‐daily fixed‐dose combination tablet of abacavir and lamivudine improves patient adherence and satisfaction with therapy

• Published in: HIV medicine 2008-09, Vol.9 (8), p.667-672
• Main Authors: Maitland, D, Jackson, A, Osorio, J, Mandalia, S, Gazzard, BG, Moyle, GJ
• Format: Article
• Language: English
• Subjects: abacavir; adherence; Adult; Aged; Antiretroviral Therapy, Highly Active - methods; CD4 Lymphocyte Count; Chi-Square Distribution; Dideoxynucleosides - therapeutic use; Drug Administration Schedule; Drug Combinations; Female; HIV; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1; Humans; lamivudine; Lamivudine - therapeutic use; Male; Middle Aged; once daily; Patient Compliance; Patient Satisfaction; Reverse Transcriptase Inhibitors - therapeutic use; Statistics, Nonparametric; treatment satisfaction; Viral Load
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2008.00618.x

Background Patients prefer fewer pills and once‐daily (qd) dosing without food restrictions. We assessed the impact on adherence [by Medication Event Monitoring System (MEMS) cap monitoring] of switching from abacavir (ABC) and lamivudine (3TC) twice daily (bid) to ABC/3TC fixed‐dose formulation (FDC, Kivexa®) qd to achieve a qd regimen. Methods A randomized, open‐label, 8‐week study comparing adherence, efficacy and safety of immediate vs. delayed switching from ABC/3TC to FDC qd. Results Ninety‐four patients were dosed. Significantly improved adherence was observed at week 4 with qd ABC/3TC across all three adherence variables: taking compliance 99.2% (90.7–100%) vs. 96.6% (60.0–100%) (P=0.017); dosing compliance 97.1% (64.3–100%) vs. 91.9% (33.3–100%) (P=0.016); and timing compliance 95.5% (53.8–100%) vs. 86.3% (4.3–100%) (P=0.006). Treatment satisfaction increased significantly at week 4 with ABC/3TC qd [92% (82–99%) vs. 85% (75–93%) (P=0.004)]. Two patients were withdrawn from the study because of intolerance to ABC/3TC. Conclusions Switching from ABC and 3TC bid to ABC/3TC FDC qd significantly improved adherence by MEMS cap monitoring at week 4 and improved patient satisfaction with therapy. The results remain to be confirmed over a longer follow‐up. Use of qd regimens supports adherence and improves treatment satisfaction relative to bid regimens.