CHAPTER 14: Clinical Benefits of Single‐tablet Regimens

Since the advent of highly active antiretroviral therapy, considerable progress has been made in the treatment of HIV infection. Single-tablet regimens (STRs) represent substantial improvements in the treatment of HIV infection by providing all of the components of a safe and effective antiretroviral therapy regimen in a single pill that is dosed once daily, thereby allowing for simpler and more convenient treatment. Of the three FDA-approved STRs currently available in the USA, two consist of combinations of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI), efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) and emtricitabine/rilpivirine/tenofovir disoproxil fumarate (FTC/RPV/TDF), while the third and newest STR consists of two NRTIs plus an integrase strand transfer inhibitor (INSTI), elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF). Large clinical trials and retrospective analyses have demonstrated the advantages of these STRs over other treatment regimens, including greater adherence and persistence, better health outcomes, improved patient preference and quality of life and reduced healthcare resource utilization. Because of the demonstrated advantages of STR therapies in the management of HIV and successes in other disease areas using coformulated medications, it may be beneficial to develop future STRs for the treatment of other chronic diseases.