Once-daily abacavir in place of twice-daily administration.
OBJECTIVE
To review the safety and efficacy of a once-daily dosage regimen for abacavir, a nucleoside reverse transcriptase inhibitor.


METHODS
English-language MEDLINE and Iowa Drug Information Service database reports were accessed from 1966 to March 2005. International Pharmaceutical Abstracts was searched from 1970 to March 2005. The key words used in all searches were abacavir and Ziagen. Article bibliographies were used to identify additional relevant articles. The Internet was searched to identify abstracts of poster and oral presentations that have not yet been published. The manufacturer was also contacted to obtain unpublished information.


METHODS
Publications were included that provided information related to the safety and efficacy of abacavir when used once daily. Preference was given to randomized, double-blind, controlled trials comparing once-daily abacavir regimens with other antiretroviral regimens. Abstracts from professional meetings were included for unpublished studies, and conference coverage reviews were included if the abstracts were not available.


RESULTS
In trials directly comparing once- and twice-daily abacavir, little difference was shown in the efficacy of the 2 regimens. Despite similar adverse effect profiles, significantly more severe hypersensitivity reactions and severe diarrhea were seen with once-daily abacavir in one trial.


CONCLUSIONS
Once-daily administration of abacavir has not been shown to be inferior to twice-daily dosing, but it may put patients at increased risk for severe hypersensitivity reactions and diarrhea. More data are needed to confirm this risk.
Goedken
Amber M
AM
Iowa Drug Information Network, Iowa City, IA 52242-5000, USA.
Herman
Ronald A
RA
D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015224:Dideoxynucleosides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D018894:Reverse Transcriptase Inhibitors; D000099227:Abacavir