title: [Spanish recommendations for proper use of enfuvirtide].
abstract: Enfuvirtide is a high-cost, parenterally administered drug commonly used in late phases of HIV infection, when its efficacy may be compromised. To optimize enfuvirtide use, consensus recommendations for this purpose have been formulated by 247 physicians attending patients with HIV infection in Spain. A literature review was performed in which grades of evidence and recommendations were defined according to the origin of the data (randomized clinical trials, non-randomized studies, expert opinion). Twenty-eight local consensus meetings were held between May and September 2005 to discuss the most important aspects related to the use of enfuvirtide, following a pre-established system used in all the meetings. The main conclusions were as follows: a) enfuvirtide use is often excessively delayed and is given to patients with little chance of treatment success; b) enfuvirtide is indicated in patients who require antiretroviral treatment and for whom an optimum treatment with three other fully effective drugs cannot be designed; c) the most important prognostic factor is the availability of at least one other completely active drug; d) there is no infallible method to avoid the development of local reactions, but measures are available to decrease their incidence and severity; and e) patient counseling and training for correct administration of the drug are essential to improve adherence, the repercussions of local reactions and, of course, the efficacy of the treatment.
authors.affiliation: Hospital Vall d'Hebron, Barcelona, España. eribera@vhebron.net
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Pompeyo
authors.initials: P
authors.lastname: Viciana
authors.forename: Santiago
authors.initials: S
authors.lastname: Echevarría
authors.forename: Juan
authors.initials: J
authors.lastname: Flores
authors.forename: Adela
authors.initials: A
authors.lastname: Francés
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Gómez-Sirvent
authors.forename: Juan
authors.initials: J
authors.lastname: González
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Quero
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.forename: Josep
authors.initials: J
authors.lastname: Mallolas
authors.forename: Agustín
authors.initials: A
authors.lastname: Muñoz
authors.forename: Antonio
authors.initials: A
authors.lastname: Ocampo
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Jesús
authors.initials: J
authors.lastname: Santos
authors.forename: Vicente
authors.initials: V
authors.lastname: Soriano
authors.forename: Antonio
authors.initials: A
authors.lastname: Antela
authors.forename: Piedad
authors.initials: P
authors.lastname: Arazo
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: Manel
authors.initials: M
authors.lastname: Cervantes
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
mesh_terms: D000077560:Enfuvirtide; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D023581:HIV Fusion Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010349:Patient Compliance; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011379:Prognosis; D016879:Salvage Therapy
chemical_list: D015700:HIV Envelope Protein gp41; D023581:HIV Fusion Inhibitors; D010446:Peptide Fragments; D000077560:Enfuvirtide