Introducing Past Case Studies using Data from MDV Database.
Case Study (Marketing)
Switch Rates, Time-to-switch, and Switch Patterns of Antiretroviral Therapy in People Living with Human Immunodeficiency Virus in Japan, using a Hospital-claim Database
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_02.png)
Ruzicka DJ, Kuroishi N, Oshima N, et al. Switch rates, time-to-switch, and switch patterns of antiretroviral therapy in people living with human immunodeficiency virus in Japan, in a hospital-claim database. BMC Infect Dis. 2019;19(1):505. Published 2019 Jun 10. doi:10.1186/s12879-019-4129-6
Introduction
- Antiretroviral therapy (ART)
contributes to extend HIV patient’s life expectancy - Combination of the following medications have been
the recommended regimen in Japanese guidelines:
- Backbone therapy: 2 nucleoside reverse transcriptase inhibitors
- Add on of an anchor drug among:
Objectives of Study
To understand the switch rates and time-to-switch of ART regimens in patients with HIV between 2008 to 2016 in Japan
Study Design and Criteria
Study Design: Retrospective Observational Database Study.
Target Period: April 2008 – December 2016
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_03.png)
Definition of Regimen Switch
Regimen switch is referring to only when adopting anchor drug classes.
Change in anchor drug classes within 28 days of a different anchor drug is considered a change in regimen.
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_04.png)
Patient Disposition
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_05.png)
Distributions of anchor drug class and backbone in the ART regimens by year
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_06.png)
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_07.png)
Switching Patterns and Timing
Switching patterns of anchor drug class in ART regimens by switching timing from 2011 to 2016
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_08.png)
Time-to-switch
Time-to-switch of ART regimens according to anchor drug class from 2011 to 2016
![](https://en.mdv.co.jp/ebm/wp-content/uploads/2024/04/case_studies03_img_09.png)
Conclusion
- An ART regimen including INSTI maintained a low switch rate for long duration.
- The major switch was seen mainly from NNRTI or PI to INSTI for secondary treatment suggesting INSTI is rather a tentative treatment approach for HIV patients
Service used for the Case Study:
Abbreviation in Article
3TC | Lamivudine |
ABC | Abacavir |
AE | Adverse event |
ART | Antiretroviral therapy |
ATV/r | Atazanavir/ritonavir |
AZT | Zidovudine |
CI | Confidence interval |
DTG | Dolutegravir |
EFV | Efavirenz |
EI | Entry inhibitor |
FTC | Emtricitabine |
HIV | Human immunodeficiency virus |
HR | Hazard ratio |
ICD-10 | The International Statistical Classification of Diseases and Related Health Problems 10th Revision |
INSTI | Integrase strand transfer inhibitor |
NNRTI | Non-nucleoside reverse transcriptase inhibitor |
NRTI | Nucleoside reverse transcriptase inhibitor |
PI | Protease inhibitor |
PLWH | People living with human immunodeficiency virus |
TAF | Tenofovir alafenamide fumarate |
TDF | Tenofovir disoproxil fumarate |