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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Efavirenz dose reduction is safe in patients with high plasma concentrations and may prevent efavirenz discontinuations.
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Efavirenz dose reduction is safe in patients with high plasma concentrations and may prevent efavirenz discontinuations.

机译：在血浆浓度高的患者中降低依非韦伦的剂量是安全的，并可预防依非韦伦的停药。

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OBJECTIVE: To establish whether efavirenz dose reduction in patients with high plasma concentrations prevents toxicity-induced efavirenz discontinuations. METHODS: HIV-infected patients with a high efavirenz plasma concentration (>or=4.0 mg/L) while using efavirenz 600 mg once daily as part of their highly active antiretroviral therapy regimen were selected from the AIDS Therapy Evaluation in The Netherlands cohort study. These patients were classified into 2 groups. The reduced-dose group contained all patients who underwent dose reduction after the high plasma concentration measurement; the standard-dose group consisted of patients who had no dose reduction. Kaplan-Meier and Cox proportional hazards analysis were used to assess the impact of dose reduction on toxicity-induced efavirenz discontinuations. RESULTS: One hundred eighty patients with high plasma efavirenz levels were included, 47 of them subsequently had their efavirenz dose reduced from 600 mg to 400 mg once-daily, which resulted in a 41% decrease in the median efavirenz plasma concentration. At week 48, the Kaplan-Meier estimated cumulative incidence of toxicity-induced efavirenz discontinuations was 11.5% in patients who continued the standard dose versus 2.3% in patients who had a dose reduction; P = 0.066 (log-rank test). Dose reduction was not associated with loss of virological suppression. CONCLUSIONS: Dose reduction may prevent toxicity-induced discontinuations in patients with high efavirenz plasma concentrations, whereas not compromising virological efficacy.
机译：目的：确定降低血浆中高浓度依非韦伦的剂量是否可以防止毒性引起的依非韦伦停药。方法：从荷兰队列研究的艾滋病治疗评估中，选择高依非韦伦血浆浓度（> == 4.0 mg / L）且每天使用一次依非韦伦600 mg作为其高活性抗逆转录病毒疗法的一部分的HIV感染患者。这些患者分为两组。降低剂量组包括所有在高血浆浓度测量后进行了降低剂量的患者。标准剂量组由未降低剂量的患者组成。 Kaplan-Meier和Cox比例风险分析用于评估剂量减少对毒性诱导的依非韦伦停药的影响。结果：包括180名血浆依非韦伦水平高的患者，其中47名随后的依非韦伦剂量从每天600毫克降低至每天一次400毫克，这导致依非韦伦中位数血浆浓度降低41％。在第48周时，Kaplan-Meier估计，在继续使用标准剂量的患者中，由毒性引起的依非韦伦停药的累积发生率为11.5％，而在剂量减少的患者中为2.3％; P = 0.066（对数秩检验）。剂量减少与病毒学抑制作用的丧失无关。结论：降低剂量可以预防依法韦仑血浆浓度高的患者中毒引起的停药，而不会影响病毒学疗效。

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