Isentress (Raltegravir) versus Sustiva (Efavirenz) for naive patients

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The 48 week data showed similar efficacy but differences in side effects.

Laboratory adverse events profiles did not differ substantially between raltegravir and efavirenz, with the exception of serum lipids. Raltegravir was more lipid neutral than efavirenz based on levels of total cholesterol, LDL-C, and triglycerides

Drug-related clinical adverse events were reported by fewer patients in the raltegravir treatment groups than in the efavirenz group (P = 0.04 for 100, 400, and 600 mg; P = 0.07 for 200 mg). Treatment-related adverse events with a >10% incidence included nausea in patients receiving raltegravir and dizziness, headache, abnormal dreams, nausea, diarrhea, insomnia, and nightmares in patients receiving efavirenz. Neuropsychiatric symptoms (abnormal dreams, depression, nightmares, and suicidal ideation) were less common in the raltegravir groups than in the efavirenz group during the first 8 weeks of therapy and also over the entire 48 weeks (Table 5), primarily because of differences in reports of abnormal dreams (7% vs. 21%) and nightmares (0% vs. 11%).

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