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Antiretroviral therapy for initial HIV/AIDS treatment: Critical appraisal of the evidence from over 100 randomized trials and 400 systematic reviews and meta-analyses

Kanters, S. and Mills, E. J. and Thorlund, K. and Bucher, H. C. and Ioannidis, J. P.. (2013) Antiretroviral therapy for initial HIV/AIDS treatment: Critical appraisal of the evidence from over 100 randomized trials and 400 systematic reviews and meta-analyses. Clinical Microbiology and Infection, 20 (2). pp. 114-122.

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Official URL: http://edoc.unibas.ch/52603/

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Abstract

There have been over 100 randomized clinical trials of diverse regimens of antiretroviral therapy (ART) for treatment-naive HIV+ patients. A further 400 systematic reviews and meta-analyses are informed by these trials. There are, however, difficulties in using systematic reviews and meta-analyses of this clinical evidence to inform guidelines and clinical practice. Several issues can make the interpretation of comparative effectiveness challenging. In this article, we review the key challenges of interpreting multiple trials in this population. We specifically examine the network geometry of the clinical trial comparisons, the dominance of non-inferiority trial designs, issues related to potential class-effects, heterogeneous documentation of adverse events, and a relative lack of RCTs that reflect specific current clinical guideline recommendations. We conclude with recommendations for future clinical trials and meta-analyses. This article is protected by copyright. All rights reserved.
Faculties and Departments:03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB
03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB > Klinische Epidemiologie (Bucher H)
UniBasel Contributors:Bucher, Heiner C.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:1469-0691
e-ISSN:1469-0691
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:04 Oct 2017 15:23
Deposited On:04 Oct 2017 15:23

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