Browsing by Author "Khoo, Saye H."

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    Global patient safety and antiretroviral drug–drug interactions in the resource-limited setting
    (Journal of Antimicrobial Chemotherapy, 2013) Seden, Kay; Khoo, Saye H.; Back, David; Byakika-Kibwika, Pauline; Lamorde, Mohammed; Ryan, Mairin; Merry, Concepta
    Scale-up of HIV treatment services may have contributed to an increase in functional health facilities available in resource-limited settings and an increase in patient use of facilities and retention in care. As more patients are reached with medicines, monitoring patient safety is increasingly important. Limited data from resource limited settings suggest that medication error and antiretroviral drug–drug interactions may pose a significant risk to patient safety. Commonly cited causes of medication error in the developed world include the speed and complexity of the medication use cycle combined with inadequate systems and processes. In resource-limited settings, specific factors may contribute, such as inadequate human resources and high disease burden. Management of drug–drug interactions may be complicated by limited access to alternative medicines or laboratory monitoring. Improving patient safety by addressing the issue of antiretroviral drug–drug interactions has the potential not just to improve healthcare for individuals, but also to strengthen health systems and improve vital communication among healthcare providers and with regulatory agencies.
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    Steady-State Pharmacokinetics of Rilpivirine under Different Meal Conditions in HIV-1-Infected Ugandan Adults
    (Journal of Antimicrobial Chemotherapy, 2015) Lamorde, Mohammed; Walimbwa, Stephen; Kibwika, Pauline Byakika; Katwere, Michael; Mukisa, Lillian; Sempa, Joseph B.; Else, Laura; Back, David J.; Khoo, Saye H.; Merry, Concepta
    To investigate the effect of food on the steady-state pharmacokinetics of rilpivirine when administered as a fixed-dose combination tablet containing tenofovir disoproxil fumarate, emtricitabine plus rilpivirine (TDF/FTC/RPV) in HIV-1-infected Ugandan patients.This was an open-label, three-period, longitudinal pharmacokinetic study with patients serving as their own controls. Fifteen consenting and virologically suppressed HIV-1-infected adults were switched from an efavirenz-based regimen to TDF/FTC/RPV for 56 days. Enrolled patients underwent 24 h blood sampling with TDF/FTC/RPV dosing in the fasted state (day 42), with a low-fat meal (11 g of fat/353 kcal, day 49) and with a moderate-fat meal (19 g of fat/589 kcal, day 56; reference). A viral load assessment was performed on day 56.Rilpivirine AUC0–24 was significantly decreased by 16% (geometric mean ratio, 90% CI: 0.84, 0.73–0.96) during administration in the fasted state when compared with AUC0–24 during administration with a moderate-fat meal. Similarly, rilpivirine C24 was significantly decreased by 21% (0.79, 0.65–0.97) in the fasted state compared with a moderate-fat meal. Pharmacokinetic parameters were unchanged during administration with a low-fat meal, except for C24, which was significantly increased by 15% (1.15, 1.01–1.31) when compared with the moderate-fat meal. Rilpivirine Cmax was similar under the three meal conditions. Virological suppression was unchanged at the end of the study.A food effect was observed for steady-state pharmacokinetic parameters of rilpivirine (AUC0–24 and C24) when TDF/FTC/RPV was administered in the fasted state compared with the moderate-fat meal. The TDF/FTC/RPV formulation can be administered with either a low-fat or moderate-fat meal.
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    Steady-state pharmacokinetics of rilpivirine under different meal conditions in HIV-1-infected Ugandan adults
    (Journal of Antimicrobial Chemotherapy, 2015) Lamorde, Mohammed; Walimbwa, Stephen; Byakika-Kibwika, Pauline; Katwere, Michael; Mukisa, Lillian; Sempa, Joseph B.; Else, Laura; Back, David J.; Khoo, Saye H.; Merry, Concepta
    Over 24 million people are living with HIV in sub-Saharan Africa, the region that also experiences the highest prevalence of food insecurity. ART is the cornerstone for management of HIV, but few treatment options are available in African countries. The WHO recommends that first-line antiretroviral regimens should include one of two NNRTIs, either efavirenz or nevirapine. Although these drugs are efficacious, some patients may experience treatment-limiting toxicities, drug resistance or drug interactions with these agents; hence the need for more treatment options.