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M94A2870.TXT
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Document 2870
DOCN M94A2870
TI Effect of Concorde Study release on anti-retroviral (AR) use in
community programs for clinical research on AIDS (CPCRA) trials.
DT 9412
AU Ward TT; Sampson J; Wentworth D; Wallace JA; Portland OR VA Med Ctr.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):206 (abstract no. PB0253). Unique
Identifier : AIDSLINE ICA10/94369705
AB OBJECTIVE: Widespread attention was given to two studies of AR therapy
at the Berlin International AIDS meetings in mid-June 1993: the Concorde
Study of AZT Monotherapy (mono) and the ACTG 175 study of combination
(combo) AZT and ddI. We sought to determine the impact of rapidly
changing HIV therapeutic information on practice patterns of clinicians.
METHODS: We retrospectively compared all patients (pts) who were newly
enrolled in CPCRA trials not before (Jan-Jun 93) vs. after (Jul-Dec 93)
these meetings to access the trials' impact on actual AR use. RESULTS:
630 and 640 pts were enrolled in trials before and after the Berlin
meetings, of whom 69.7 and 65.2%, respectively, received AZT, ddI, or
ddC mono- or combo therapy. There was a significant (p < 0.001) decrease
in the proportion of pts who received AZT before (.598) vs. after (.483)
Berlin, with no significant difference in the proportion of pts
receiving ddI or ddC. AZT use was significantly decreased both among the
CD4 < 200 (n = 945, p = 0.006) and 200-500 (n = 268, p < 0.001) strata.
For those 694 pts who received AR mono, there were significant decreases
in the frequency of AZT use for all pts with entrance CD counts < 500 (p
< 0.001), 200-500 (p = 0.017) and < 200 (p = 0.02). The frequency of ddI
and ddC mono use were not significantly changed. In the 162 pts
receiving combo AR therapy, there was no change in frequency of use at
any strata, including the CD4 < 200 stratum (n = 142). DISCUSSION AND
CONCLUSIONS: A temporal association between the Berlin meetings and AZT
mono but not combo use was observed, with no observable effect on ddI or
ddC use. More efficient methods of rapidly disseminating research
results need to be investigated. The issue of unclear analysis of
non-peer reviewed research data may unintentionally impact patterns of
care by HIV clinicians.
DE Clinical Trials Comparative Study *Congresses
Didanosine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Drug Therapy,
Combination Drug Utilization/STATISTICS & NUMER DATA Human HIV
Infections/*DRUG THERAPY *Information Services Multicenter Studies
*Physician's Practice Patterns Retrospective Studies
Zalcitabine/ADMINISTRATION & DOSAGE/THERAPEUTIC USE
Zidovudine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).