title: [Evidence-based therapeutic drug monitoring for nevirapine].
abstract: Nevirapine, a HIV non nucleosidic reverse transcriptase inhibitor, displays an inter-individual variability in its pharmacokinetics parameters, related to its hepatic metabolism. Based on literature, is the nevirapine therapeutic drug monitoring relevant? In naïve and pre-treated HIV infected patients, the probability of achieving and maintaining an undetectable HIV viral load was significantly associated with a nevirapine plasma trough concentration (C(trough)) > 4 000 ng/mL. The probability of virologic failure was significantly associated with a C(trough) < 3 000 ng/mL. Concerning the exposure-toxicity relationship, the emergence of hepatotoxicity was more frequently associated with high C(trough), especially in case of HCV coinfection. Non-randomized studies have reported the interest of nevirapine therapeutic drug monitoring to optimize the virologic response and, to a lesser extent, to prevent hepatotoxicity. Therefore, the level of evidence of the interest of nevirapine therapeutic drug monitoring is "recommended".
authors.affiliation: Laboratoire de Pharmacologie Clinique et Toxicologie, CHU Besançon, France. patrice.muret@univ-fcomte.fr
authors.forename: Patrice
authors.initials: P
authors.lastname: Muret
authors.forename: Sarah
authors.initials: S
authors.lastname: Piedoux
authors.forename: Caroline
authors.initials: C
authors.lastname: Solas
authors.forename: Sylvie
authors.initials: S
authors.lastname: Quaranta
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010597:Pharmacogenetics; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine