Optimizing Treatment

Considerations When Optimizing Regimens

A variety of important factors should be considered in the treatment decision

Providers may hesitate to change a patient’s regimen, but there may be compelling reasons to do so, including1:

Reducing pill burden

Tolerability and toxicity considerations

Potential drug-drug interactions

Food requirements

Patient access

Barrier to resistance

According to the DHHS guidelines, the fundamental principle of regimen optimization is to maintain viral suppression without jeopardizing future treatment options.1

A regimen’s barrier to resistance is important to consider when choosing a treatment, even if a patient is virally suppressed1

As discussed in the DHHS guidelines, the SWITCHMRK 1 and 2 studies illustrated the importance of considering the possibility of underlying drug resistance before switching therapy in those with virologic suppression. This is particularly important when the new regimen may not include three fully active agents and when the new regimen may have a lower overall barrier to resistance.1

When considering a regimen change, it is important to consider all its attributes and whether it is the right fit for your patient

How do you approach real-world discussions for switching treatments?

Having conversations around optimizing regimens can help providers and patients who are assessing their options.

Wide Diversity in Clinical Trial Data May Help Inform Treatment Discussions

Increasing the amount of clinical trial data available for specific populations may enhance patient trust2

Increasing diversity and inclusion in clinical trials can provide more generalizable evidence—potentially improving patient trust and advancing health equity. Enhanced patient trust can lead to better retention in care, especially when patients are included as partners.2

While every patient is different, people living with HIV may be inclined towards taking a collaborative approach to shared clinical decision-making.

7 out of 10 patients preferred to engage in shared decision-making in a 2010 study

In a 2010 study, 7 out of 10

patients preferred to engage in shared decision-making when it came to their HIV treatment (n=434)3

Please see full Prescribing Information for BIKTARVY® and DESCOVY®, including BOXED WARNINGS.

DHHS, US Department of Health and Human Services

Reference: 1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated May 26, 2023. Accessed June 26, 2023. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf 2. Corneli A, Hanlen-Rosado E, McKenna K, et al. Enhancing diversity and inclusion in clinical trials. Clin Pharmacol Ther. 2023;113(3):489-499. 3. Kumar R, Korthuis PT, Saha S, et al. Decision-making role preferences among patients with HIV: associations with patient and provider characteristics and communication behaviors. J Gen Intern Med. 2010;25(6):517-523.