Comparing effectiveness of AIDS medications

There is a wide assortment of drugs available today for treating HIV/AIDS, so the challenge for clinicians is to determine what drug regimen will work best for any given patient.

Douglas Owens and his colleagues at the Stanford Center for Health Policy are using more than $1 million in stimulus grant funding to look at the comparative effectiveness and cost effectiveness of different ARV regimens in two important patient populations.

In one case, they will look at the best treatments for patients, particularly older patients, who have cardiovascular problems or who at risk of cardiovascular problems, as some ARVs are believed to harm the heart. For this study, they will rely on existing data for more than 55,000 HIV patients at the Veterans Affairs medical centers.

The researchers also will look at drug options for patients who have tried multiple regimens and failed to respond because they have become resistant to the various treatments available. The scientists will examine whether the newer, more expensive drugs — including second-generation protease inhibitors, integrase inhibitors and entry inhibitors — are a viable alternative for these patients.

In both populations, the aim is to help people chose the best regimen that will work for them.

The grant will create two new jobs, including a research assistant position that is giving a recent Stanford graduate his first job out of college.  It will also help retain two existing jobs, and provide part-time support to four Stanford faculty and some staff at the Palo Alto Veterans Affairs Health Care System, where Owens, a professor of medicine at Stanford, is based.