BMJ  2004;328:253 (31 January), doi:10.1136/bmj.328.7434.253

Commentary

Indirect comparisons: a novel approach to assessing the effect of anti-HIV drugs

Jens D Lundgren, chief physician, Copenhagen HIV Programme1, Andrew N Phillips, professor of epidemiology2

1 Copenhagen HIV Programme, Section 044, Hvidovre University Hospital, 2650 Hvidovre, Denmark, 2 Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and Universtiy College Medical Schools, London NW3 2PF

Correspondence to: J D Lundgren jdl@cphiv.dk

The first 150 words of the full text of this article appear below.

The need to evaluate rapidly and provide access to anti-HIV drugs led, in 1997, to an expedited drug approval process, based on short term trials using viral load and CD4 cell counts as surrogate end points for clinical AIDS. The evidence for efficacy of many drugs is therefore based solely on trials using such end points, but it is useful to evaluate studies using clinical end points where available.

Yazdanpanah and coworkers used an indirect comparison of clinical outcomes from randomised controlled trials to compare the effects of drugs from either the protease inhibitor or the non-nucleoside reverse transcriptase inhibitor (NNRTI) class with two nucleoside reverse transcriptase inhibitors (nucleosides).1 This approach introduces a novel concept to improve further our understanding of the relative efficacy of the two classes. This review suggests a better efficacy of the protease inhibitors than the NNRTIs.

It is important to understand the context of the . . . [Full text of this article]


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Relevant Article

Clinical efficacy of antiretroviral combination therapy based on protease inhibitors or non-nucleoside analogue reverse transcriptase inhibitors: indirect comparison of controlled trials
Yazdan Yazdanpanah, Daouda Sissoko, Matthias Egger, Yves Mouton, Marcel Zwahlen, and Geneviève Chêne
BMJ 2004 328: 249. [Abstract] [Full Text] [PDF]

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