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Author Topic: Three med combos proposed  (Read 2905 times)

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Offline LordBerners

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Three med combos proposed
« on: December 11, 2007, 12:56:40 pm »
My doctor has proposed three possible medical combinations for me to consider:

1) Truvada + Efavirenz

2) Truvada + Ritonavir + Atazanavir

3) Truvada + Abacavir + Zidovudine

Can any of you gentlemen and ladies comment on good or bad aspects of these choices?
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Please, just call me Berners.. or Baron.

Offline keyite

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Re: Three med combos proposed
« Reply #1 on: December 11, 2007, 06:59:36 pm »
As I'm not on meds I don't have experience of any of these. However, the third and last combination you outline sounds very odd to me - they all belong to the same class (NRTIs) and I wouldn't have thought that would be a particularly effective combo. Normally you combine drugs from different classes.

Also, zidovudine (AZT) is no longer a recommended first-line drug. That's not least because it is linked to lipodistropy. A more common first-line combination might be Epzicom (abacavir + lamivudine) and Sustiva (efavirenz).

With abacavir it is important to know that a small number of people get a severe allergic reaction to it, but also that a simple lab test can predict very accurately if you are likely to be in this group. If abacavir is chosen then make sure this test is performed if it hasn't already been done.

Hope that helps.
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Offline newt

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Re: Three med combos proposed
« Reply #2 on: December 11, 2007, 07:02:23 pm »
The first 2 options are standard and follow the formula for 1st time treatment of 2 nukes (Truvada) + either an NNRTI (Sustiva) or boosted PI (atazanavir + ritonavir booster). This fulfils the rule of thumb for making an effective combination of using 3+ drugs from 2 or more classes.

The third, being 4 nukes, is not recommended for 1st line treatment.  3 nuke only combinations have a high rate of failure. 4 is unlikely to be better. For me, this is not a well suggested option unless there is a particular reason that leads to it being on the table << I can't think of any that would make it better or equal to option 1 or 2 though.

Truvada is one of the 2 nuke pairings recommended in many guidelines (it's tenofovir + FTC). The other is Epzicom aka Kivexa (abacavir + 3TC). Both have pros and cons. Both effective and generally easy to take. Seems to fall to doctor preference more than anything, which one you use.

- matt
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"The object is to be a well patient, not a good patient"

Offline trellium

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  • stArk raving Borg
Re: Three med combos proposed
« Reply #3 on: December 12, 2007, 02:57:20 am »
LordBerners,

Unless you are enrolling in the ALTAIR trial, I would go with well proven #1 or #2.
#3 is highly experimental and untested for treatment-naive patients.

http://clinicaltrial.gov/ct2/show/NCT00335322?term=hiv&intr=tenofovir%2C+abacavir%2C+atazanavir%2C+Zidovudine&rank=2

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