Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
John Cavenagh, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not Etravirine (ETR) decreases adverse reactions on the central nervous system (CNS) compared to Efavirenz (EFV) in Human Immunodeficiency Virus (HIV) positive patients.
STUDY DESIGN: Review of three, English language, primary randomized controlled trial studies published in 2011.
DATA SOURCES: Three randomized controlled trials studying the possible decrease of ADR’s in HIV positive patients who are taking Efavirenz compared to study medication Etravirine.
OUTCOME(S) MEASURED: Outcomes measured were by surveys from patients that assess the development or cessation of CNS ADR’s. The self reported questionnaire was grade on a scale of 0-4 rating where 4 was reported as life threatening. Another survey included the Depression Anxiety and Stress Scale (DASS). The CNS ADR’s included, but was not limited to dizziness, depression, anxiety, headache, and somnolence.
RESULTS: In the article by Nelson et. al., there was a statistically significant benefit for etravirine over efavirenz for NPS adverse events, most of the adverse events were grade 1 (mild) or grade 2 (moderates) in intensity. There was no significant difference between the arms in the number. The other two article reviews showed that ETV was not superior to EFV regarding CNS ADR’s.
CONCLUSIONS: Efavirenz is not superior to Etravirene, in regards to decreasing CNS ADR’s in HIV positive patients.
Smith, Angelo D. T., "Does Etravirine Decrease Central Nervous System (CNS)/Neuropsychiatric (NPS) Adverse Events Compared to Efavirenz, in HIV Positive Patients?" (2013). PCOM Physician Assistant Studies Student Scholarship. 147.