Evidence map›Paper›PMID 28763473›Full record

Observational studyPloS one2017

Efficacy and safety of switching from branded to generic antiretrovirals in virologically suppressed HIV-infected patients.

Nicola Gianotti, Andrea Poli, Laura Galli, Michela Franzin, Patrizia Tadini, Nadia Galizzi, Alessia Carbone, Marco Merli, Camilla Muccini, Chiara Oltolini and 4 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

Nicola GianottiInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.ORCID http://orcid.org/0000-0002-7182-5080
Andrea PoliInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Laura GalliInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Michela FranzinPharmacy, San Raffaele Scientific Institute, Milano, Italy.
Patrizia TadiniPharmacy, San Raffaele Scientific Institute, Milano, Italy.
Nadia GalizziInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Alessia CarboneInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Marco MerliInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Camilla MucciniInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Chiara OltoliniInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Andrea AndolinaInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Vincenzo SpagnuoloInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Adriano LazzarinInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Antonella CastagnaInfectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
San Raffaele University of Rome · ITVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAim of this study was to evaluate the efficacy and the safety of switching from branded to generic antiretrovirals in patients with HIV-RNA <50 copies/mL.

methodsMatched-cohort study of patients followed at a single clinical center. Since September 2014, all patients with HIV-RNA <50 copies/mL who were receiving branded lamivudine or zidovudine/lamivudine or efavirenz were switched to the generic compound (switchers) and matched, in a ratio 1:1, for age (±5 years), gender, anti-HCV antibodies, nadir and (±50 cells/μL) baseline CD4+ count (±100 cells/μL), duration of antiretroviral therapy (±1 year), with patients with HIV-RNA <50 copies/mL, on treatment with unavailable generic compounds (non-switchers). Incidence rates (IR) of different outcomes were calculated and compared by Poisson regression model. A confirmed HIV-RNA ≥50 copies/mL defined virological failure; any change in the antiretroviral regimen was defined as treatment discontinuation.

resultsFour hundred forty patients were switched to generic compounds (268 [61%] on lamivudine, 65 [15%] on zidovudine/lamivudine, 87 [20%] on efavirenz and 20 [4%] on efavirenz and either lamivudine or zidovudine/lamivudine). Over a median follow-up of 15.0 (12.1-15.7) months, virological failure occurred in four switchers (IR: 0.07 [0.02-0.18]/100-person months of follow-up [PMFU]) and in ten non-switchers (IR: 0.20 [0.10-0.35]/100-PMFU) (p = 0.0003), while treatment discontinuation occurred in 118 switchers (IR: 2.05 [1.70-2.44]/100-PMFU) and in 128 non-switchers (IR: 2.37 [1.99-2.81]/100-PMFU) (p = 0.699).

conclusionsAfter more than one year of follow-up, we found no evidence of increased risk of reduced efficacy or increased toxicity after switching from branded to generic lamivudine or zidovudine/lamivudine or efavirenz.

Indexed as

AlkynesAnti-HIV AgentsBenzoxazinesCohort StudiesCyclopropanesDideoxynucleosidesDrug CombinationsDrugs, GenericDrug Therapy, CombinationFemaleFollow-Up StudiesHIV-1HIV InfectionsHumansLamivudineMaleAlkynesAnti-HIV AgentsBenzoxazinesCyclopropanesDideoxynucleosidesDrug CombinationsDrugs, GenericefavirenzLamivudinelamivudine, zidovudine drug combinationRNA, ViralZidovudine

Identifiers

PMID28763473
PMCPMC5538668
OpenAlexW2740557605

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.