[Spanish recommendations for proper use of enfuvirtide].

Abstract

Enfuvirtide is a high-cost, parenterally administered drug commonly used in late phases of HIV infection, when its efficacy may be compromised. To optimize enfuvirtide use, consensus recommendations for this purpose have been formulated by 247 physicians attending patients with HIV infection in Spain. A literature review was performed in which grades of evidence and recommendations were defined according to the origin of the data (randomized clinical trials, non-randomized studies, expert opinion). Twenty-eight local consensus meetings were held between May and September 2005 to discuss the most important aspects related to the use of enfuvirtide, following a pre-established system used in all the meetings. The main conclusions were as follows: a) enfuvirtide use is often excessively delayed and is given to patients with little chance of treatment success; b) enfuvirtide is indicated in patients who require antiretroviral treatment and for whom an optimum treatment with three other fully effective drugs cannot be designed; c) the most important prognostic factor is the availability of at least one other completely active drug; d) there is no infallible method to avoid the development of local reactions, but measures are available to decrease their incidence and severity; and e) patient counseling and training for correct administration of the drug are essential to improve adherence, the repercussions of local reactions and, of course, the efficacy of the treatment.

• Authors: Esteban Ribera, Santiago Moreno, Pompeyo Viciana, Santiago Echevarría, Juan Flores, Adela Francés, Juan Luis Gómez-Sirvent, Juan González, José Hernández-Quero, Fernando Lozano, Josep Mallolas, Agustín Muñoz, Antonio Ocampo, Joaquín Portilla, Federico Pulido, Antonio Rivero, Jesús Santos, Vicente Soriano, Antonio Antela, Piedad Arazo, José Ramón Arribas, Manel Cervantes, Pere Domingo
• Journal: Enfermedades infecciosas y microbiologia clinica (Enferm Infecc Microbiol Clin) Vol. 25 Issue 2 Pg. 131-42 (Feb 2007) ISSN: 0213-005X [Print] Spain
• Vernacular Title: Recomendaciones españolas sobre el uso adecuado de enfuvirtida.
• PMID: 17288910 (Publication Type: Consensus Development Conference, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• HIV Envelope Protein gp41
• HIV Fusion Inhibitors
• Peptide Fragments
• Enfuvirtide

Topics

• Enfuvirtide
• HIV Envelope Protein gp41 (administration & dosage, adverse effects, therapeutic use)
• HIV Fusion Inhibitors (administration & dosage, adverse effects, therapeutic use)
• HIV Infections (drug therapy)
• Humans
• Patient Compliance
• Peptide Fragments (administration & dosage, adverse effects, therapeutic use)
• Prognosis
• Salvage Therapy