final program.qxd - Parallels Plesk Panel

FP 2.8
Radata - An internet-based system for salvage patients with the possibility of expert
advice
Lorenzen T, Graefe K, Stoehr A, Hoffmann C, Plettenberg A
ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany
Objective
Failure of antiretroviral therapy (ART) is a complex area, which involves many factors such
as resistances, drug levels and patients adherence. The Radata-system considers these
aspects. A further option of this cohort is the possibility to obtain expert advice to support
therapeutic decisions via internet.
Methods
Patients may be included while in need of a new ART due to increased viral load or
toxicity. Radata collects demographic data, informations concerning medical history,
current lab results, patients opinion and requirements to future ART and course of
disease. Depending on physicians choice, laboratories are informed about upcoming
resistance analysis (RA) or therapeutic drugmonitoring (TDM). Experts may review the
data online and perform their recommendation. All data entries are directly entered online
into the database.
Results
Since 2002, 593 patients out of 75 centers have been included in the Radata-Cohort. 498
RA and 462 TDM are available. Expert advice has been performed in 435 patients. For
383 patients ART-switch is documented. To date, median observation time for all patients
is 9 months, maximum 33 months. Median number of ART regimens prior to recruitment
was 6, time since first ART initiation was 90 months. Patients had in median 6 reverse
transcriptase and 4 protease resistance mutations. Experts recommended in median
4 antiretroviral substances (Ritonavir booster excluded) and physicians utilised
recommendations in most cases. 12 month follow up showed median viral load decrease
of 0.3 log10 and CD4 increase of 28 c/µl.
Conclusions
The Radata-Cohort was initiated 2002. The aim was a better understanding of
mechanisms of therapeutic failure in HIV-infected patients. Therefore an internet-based
system was developed to collect data of different specialities involved in ART-decisions.
Patients included are heavily pretreated and have very limited options for future therapies.
Nevertheless viral load and CD4-cell counts improved slightly over 12 months.
“ Focusing FIRST on PEOPLE “ 268 w w w . i s h e i d . c o m