title: Once-daily single-tablet regimens: a long and winding road to excellence in antiretroviral treatment.
abstract: Once-daily single-tablet regimens represent the paramount simplification of antiretroviral treatment achieved so far. They include drugs with favorable pharmacokinetics that allow once-daily administration, that do not need dose adjustments, have no additional toxicities, and do not require dissimilar intake conditions. Co-formulated efavirenz/tenofovir disoproxil fumarate/emtricitabine has been a gold standard of initial therapy since its approval in 2006. Galenic research and industry patent agreements may allow availability of single-tablet regimens with HIV-1 nonnucleoside reverse transcriptase inhibitors (efavirenz or rilpivirine), integrase inhibitors (cobicistat-boosted elvitegravir or dolutegravir), and protease inhibitors (cobicistat-boosted darunavir), combined with either tenofovir disoproxil fumarate/emtricitabine or abacavir/lamivudine. The introduction of the new phamacoenhancer cobicistat as a potential substitution for ritonavir and the investigational agent GS-7340, with one-tenth the tenofovir mass, is a breakthrough in antiretroviral drug development. Many HIV-1-infected patients who are treatment-naive or treatment-experienced with susceptible virus will potentially have more options to reduce pill burden and optimize dosage schedules with one pill once-daily regimens.
authors: Lluita contra la SIDA Foundation. HIV Unit, University Hospital Germans Trias i Pujol, Badalona, Spain. jmllibre@flsida.org
authors: Josep M
authors: JM
authors: Llibre
authors: Bonaventura
authors: B
authors: Clotet
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000494:pharmacology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D004338:Drug Combinations; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D005260:Female; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D063065:Organophosphonates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D010078:Oxazines / Q000008:administration & dosage* / Q000493:pharmacokinetics; D017060:Patient Satisfaction; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D063065:Organophosphonates; D010078:Oxazines; D018894:Reverse Transcriptase Inhibitors; D003841:Deoxycytidine; D000225:Adenine