DataSheet_1_What Is the Most Appropriate Induction Regimen for the Treatment of HIV-Associated Cryptococcal Meningitis When the Recommended Regimen Is.doc (158.5 kB)

DataSheet_1_What Is the Most Appropriate Induction Regimen for the Treatment of HIV-Associated Cryptococcal Meningitis When the Recommended Regimen Is Not Available? Evidence From a Network Meta-Analysis.doc

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posted on 30.06.2020, 11:30 by Yao Li, Xiaojie Huang, Yuanyuan Qin, Hao Wu, Xiaofeng Yan, Yaokai Chen
Aims

Our object was to find the most appropriate, most effective, and most readily available of four induction regimens for HIV-associated cryptococcal meningitis (CM) (Regimen A: 1 week of AmB plus 5-FC followed by 1 week of fluconazole, Regimen B: 1 week of AmB plus fluconazole followed by 1 week of fluconazole, Regimen C: 2 weeks of AmB plus 5-FC, Regimen D: 2 weeks of AmB plus fluconazole), given the vast differences between resource-limited and resource-abundant settings regarding therapeutic drug accessibility, availability, and affordability for HIV-associated (CM).

Methods

We conducted a network meta-analysis to compare the therapeutic efficacy and safety of four different induction treatment regimens.

Results

The 10-week mortality of Regimen A was significantly lower than that of Regimen B and D, and the 2-week mortality of Regimen A was significantly lower than that of Regimen B. Furthermore, there were no statistically significant differences in 10-week mortality, 2-week mortality, as well as in effective fungicidal activity (EFA) over the first 2 weeks among Regimens B, C, and D. The statistical differences in adverse events between Regimen B and Regimen D, and Regimen C and Regimen D were not calculated to be significant.

Conclusions

Our results indicate that, 1 week of AmB plus 5-FC followed by 1 week of fluconazole is superior to the three other studied regimens, and that when 5-FC is not available, accessible, or affordable, 2 weeks of AmB plus fluconazole or 1 week of AmB plus fluconazole followed by 1 week of fluconazole is an appropriate substitution for 2 weeks of AmB plus 5-FC.

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