Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:132.
Objective/Description: Results from the Anglo-French MRC/ANRS Concorde
trial released in June, 1993, suggest that there is little benefit for
asymptomatic patients to start ZDV therapy. The objective of this study
is to examine the effect of the Concorde study on the prescribing
practices of physicians, by comparing the rates of initiation of ZDV
therapy before and after the Concorde results were released. Method: The
Government of Ontario funds ZDV therapy for all HIV-infected Ontario
residents through the HIV Project Centre. Enrollment records were drawn
from the HIV Project Centre's ZDV Registry. Between October, 1990 (ZDV
licensure in Canada) and July, 1993, 2,877 patients were enrolled on
ZDV. The preliminary post-Concorde time period used was the period from
June, 1993 while the pre-Concorde era was the period before this time.
Results: In 1993, the mean number of ZDV enrollments dropped by 45.4
percent in the months following the Concorde study compared to the
previous months, the post-Concorde enrollments being the lowest since
ZDV's licensure. Specifically, the decrease was seen in the number of
AIDS, ARC and asymptomatic patients initiating therapy, with percent
decreases of 13 percent, 58 percent and 52 percent, respectively.
Conclusions: There has been a substantial reduction in the initiation of
ZDV therapy following the release of the Concorde study results,
suggesting that the physicians treating HIV/AIDS in Ontario have changed
their prescribing practice. Surprisingly, the decrease has not been
confined to asymptomatics, but has also been seen in symptomatic
patients. Additional results will be presented to determine if this
trend continues, and to evaluate physician education needs.
Acyclovir/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE CD4 Lymphocyte Count
Ditiocarb/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Drug Therapy,
Combination Human HIV Infections/*DRUG THERAPY Pneumonia,
Pneumocystis carinii/PREVENTION & CONTROL Retrospective Studies