Gene/Protein Disease Symptom Drug Enzyme Compound
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 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Saquinavir, a protease inhibitor, received Food and Drug Administration (FDA) approval. Ritonavir and indinavir are likely to receive FDA approval by mid-1996, and three others are currently in clinical trials. Clinicians who treat HIV-positive patients will be faced with conflicting test results and multiple choices in drug therapy. All tests currently show that protease inhibitors are most effective in combination with nucleoside analog reverse transcriptase inhibitors. The issue of cross-resistance is controversial, with differing opinions on whether these treatments reduce the effectiveness of later treatments with other compounds. For the most effective treatment, patients should begin therapy with the maximum tolerated dosage of any of these drugs. A chart summarizes each of the six drugs' developmental statuses. Clinicians are cautioned to consider variables other than viral load in determining which drugs to prescribe; side effects, cost, drug interactions, tissue distribution and palatability are also important factors to consider. Test results of the six drugs are reviewed.
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PMID:The rolling uncertainties of antiprotease prescribing. 1136 41

Saquinavir (Invirase) is the first protease inhibitor to gain Food and Drug Administration (FDA) approval for treatment of HIV. It works by blocking a part of the HIV called protease, causing HIV to make copies of itself that cannot infect new cells. It is most effective when prescribed in conjunction with one of the nucleoside analog drugs--AZT, ddI, ddC, d4T, or 3TC. HIV can become resistant to saquinavir, which may also make HIV resistant to other protease inhibitors. Saquinavir is not well absorbed by the body, and is very expensive when prescribed in doses high enough to be very effective. It is absorbed better when taken with food, and grapefruit juice may increase the levels in the body. The drug seems to have few side effects other than gastrointestinal upset.
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PMID:Saquinavir (Invirase). 1136 96

The recent approval of three protease inhibitors introduces a welcome element of choice into HIV treatment programs. Ritonavir (Norvir), indinavir (Crixivan), and saquinavir (Invirase) all prevent HIV from replicating, leading to lower viral loads and a slower disease progression. However, patients must continue taking the drugs once they begin therapy; stopping the treatment or reducing the dosage can lead to resistance. Long term data is not yet available on toxicity or drug interactions. All three drugs are most effective when used in combination therapy.
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PMID:Freedom of choice. 1136 32

The Food and Drug Administration (FDA) approved two new protease inhibitors for treatment of AIDS. Ritonavir (Norvir) and indinavir (Crixivan) have been approved for both monotherapy and combination therapy, and appear to have relatively few side effects. Reports on clinical trials of both drugs are reported. Saquinavir (Invirase) also has FDA approval, but currently has a low absorption rate; better formulations are expected to increase absorption. Early trials indicate that triple drug combinations may suppress HIV replication to very low levels.
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PMID:FDA approves 2 new protease inhibitors: ritonavir (Norvir) and Crixivan (Indinavir sulfate). Food and Drug Administration. 1136 92

The Food and Drug Administration (FDA) approved two new protease inhibitors--ritonavir and indinavir--for the treatment of HIV infection in adults. Ritonavir (Norvir), developed by Abbott Laboratories, received full approval for use alone or in combination with nucleoside analogue medications in patients with advanced HIV disease. Two encouraging studies on ritonavir are described. An ongoing phase III trial showed mortality to be 43 percent lower than for patients receiving standard therapy alone. In a separate study, untreated HIV-infected individuals who were given a triple combination of ritonavir plus AZT and ddC showed significant increases in CD4+ T cells counts and decreases in viral load for at least six months. Indinavir (Crixivan), developed by Merck, received accelerated approval for monotherapy and combination therapy for the treatment of HIV infection in adults when therapy is warranted. New data on indinavir showed decreases in levels of HIV in 22 out of 25 patients who had taken a triple combination of indinavir, AZT and 3TC. In another study of patients taking a combination of indinavir, ddI, and AZT, 60 percent of the patients' HIV levels were reduced to undetectable levels. In addition to ritonavir and indinavir, saquinavir (Invirase, Hoffmann-La Roche) is another protease inhibitor approved for use in conjunction with nucleoside analogues for the treatment of HIV infection.
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PMID:Two new protease inhibitors approved by FDA. Food and Drug Administration. 1136 99

The revised HIV Adult Standard of Care guidelines, produced by ACT UP/Philadelphia, are printed. The extensive table summarizes the minimum standard of care needed for individuals with HIV infection to maximize their quality and length of life. Divided into sections by T4 cell count, the table includes diagnostic tests and exams that patients may wish to have done at certain times in their disease progression. Treatment options are suggested for HIV disease, opportunistic infections, and other AIDS-related symptoms. Highlights of the many discussions on protease inhibitors at the 11th International AIDS Conference in Vancouver are described. Saquinavir has the lowest bioavailability of the three approved protease inhibitors and is awaiting new formulation. Ritonavir works to raise CD4 counts, drop viral load and decrease morbidity and mortality. However, it is poorly tolerated in about half of all users who describe gastrointestinal trauma. Indinavir has been shown to decrease viral loads to undetectable levels for 48 weeks, and shows promise for sustaining that measure for longer periods. Nelfinavir will likely be approved in early 1997. In addition, viral load monitoring has become a significant measure in guiding the efficacy of combination therapies, when used in conjunction with CD4 tests. The Philadelphia Water and Health Departments are suggesting that individuals not boil their water, despite outbreaks among people with AIDS of cryptosporidium. Filtered and bottled water are safer alternatives until there is a resolution.
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PMID:HIV adult standard of care. ACT UP. 1136 24

The Food and Drug Administration (FDA) warns that the antihistamine terfenadine, found in Seldane and Seldane-D, cannot be taken with Crixivan, Norvir, Invirase, Fortovase, and Viracept. Taking terfenadine products with these anti-HIV drugs can lead to a potentially fatal heart condition. The FDA formerly suggested taking the drug off the market and replacing it with Allegra (faxofenadine hydrochloride), a safer drug.
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PMID:Seldane warnings. 1136 51

The Food and Drug Administration (FDA) approved Fortovase, the new soft gel formulation of saquinavir, for treating HIV infection in adults. The gel delivers much more of the drug to the blood than the previous dosage form. The primary side effects are diarrhea, nausea, and abdominal discomfort. A new U.S. trial designed to compare Fortovase taken three times a day versus twice a day is now accruing patients. Contacts are provided for more information on this trial.
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PMID:Fortovase approved: new saquinavir formulation. 1136 7

Several new drugs are under development, and four are expected to reach the U.S. market during 1998. Some of the drugs are variations of existing drugs, such as Fortovase, a soft gel formulation of saquinavir. Several protease inhibitors and non-nucleoside reverse transcriptase inhibitors are also being developed and tested. Questions remain about how effectively the drugs work in combination with each other, which combinations are least likely to lead to resistance and HIV mutation, and which may have potentially serious side effects associated with their use. There is concern with some of these new drugs that resistance to earlier drugs may have a cumulative effect, lessening the effectiveness of the medications.
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PMID:The medical merry-go-round: drugs for 1998 are new but not novel. 1136 84

The indications, cost, dose, side effects, pharmacokinetics, and drug interactions for soft-gel saquinavir and grepafloxacin are outlined. The bioavailability of soft-gel saquinavir (Fortovase) compared with the hard gel formulation (Invirase) is discussed. Grepafloxacin (Raxar), an oral fluoroquinolone from Glaxo-Wellcome, is active against nearly all strains of S. pneumoniae and will be potentially advantageous for pneumococcal pneumonia in HIV-infected patients. An analysis of Protocol M/333/0021, comparing AZT plus delavirdine (DLV) to AZT plus 3TC and AZT plus 3TC and DLV, is reviewed. A table lists the study results.
Hopkins HIV Rep 1998 Jan
PMID:Product information. 1136 34


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