Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As combination therapy for treating HIV/AIDS grows, data on how these drugs interact becomes necessary and more complex. Information is provided on drug interactions using nonnucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors, NNRTIs and nucleoside reverse transcriptase inhibitors, DMP 266 and indinavir, AZT and delavirdine, and ritonavir and saquinavir. New concerns for some combinations have arisen concerning AZT with d4T and nevirapine with indinavir. Trial results and questions about using these drugs are provided.
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PMID:Antiviral update. 1136 72

Several trials have found that AZT added little benefit when included in two drug regimens. Human tolerance to AZT and HIV's propensity for becoming resistant to AZT are major problems. AZT remains the most prescribed HIV therapy, particularly in combination with 3TC. A popular solution for patients failing or intolerant to AZT or AZT/3TC has been d4T/3TC. AZT is known to penetrate the blood/brain barrier, thus helping to prevent or treat AIDS-related dementia. Over time, however, studies show AZT/3TC and d4T/3TC were essentially equivalent and that both should be helpful for dementia. Another study using d4T/ddI showed reduction in viral loads by 80 to 90 percent at 24 weeks, accompanied by a CD4 rise of about 40, but with significant neurological adverse effects. Combining d4T/ddI with protease inhibitors presents problems, such as a complicated dosing schedule and harsh gastrointestinal side effects. Combining hydroxyurea with d4T/ddI appears to strengthen this combination's effects. One study showed that the combination of ddI and hydroxyurea was unable to prevent the emergence of mutations that confer ddI resistance; however, the mutants were still sensitive to standard doses of ddI in the presence of hydroxyurea. One other conference report presented results of a two-arm trial comparing DuPont Merck's new DMP 266 plus indinavir to indinavir alone for 24 weeks. At trial's end, viral loads were down 2.2 logs (99.4 percent) in the indinavir arm, and CD4 counts, initially averaging 224, were up about 100 cells in both groups. The results achieved with DMP 266/indinavir rival those achieved with indinavir plus AZT/3TC or any two nucleoside analogs. DMP 266 not only is potent, but is taken only once a day.
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PMID:Dethroning AZT. 1136 6

Several new anti-HIV drugs show great promise in future treatments. Nelfinavir, especially effective in combination with AZT and 3TC, is a new protease inhibitor with fewer and milder side effects than other protease inhibitors. GW-1592 is a new nucleoside analogue that appears to be more effective than earlier ones in reducing HIV viral loads with minimal side effects. Other news drugs, GW-141U89, DMP-266, ABT-378, and MKC-442, are entering clinical trials. Scientists are considering converting HIV therapy into a specialty due to the complications, such as resistance, tolerance, and the need for compliance, of using these products.
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PMID:Preparing for the future. 1136 48

DuPont Merck is conducting clinical trials of its new non-nucleoside reverse transcriptase inhibitor, DMP 266, at more than 100 hospitals. The drug is the first anti-HIV medication to be taken only once a day, and it shows significant viral load decreases when taken in combination with indinavir. Side effects include rash, sinusitis, upper respiratory infection, and diarrhea. Enrollment information is included. Merck will announce an expanded access program in September 1997.
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PMID:DMP 266 on the horizon. 1136 36

Results of a 48-week phase II trial of efavirenz (SUSTIVA, formerly DMP 266) in combination with indinavir resulted in an average viral load reduction of 2.38 out of a possible 2.49 logs. A comparison group, receiving only indinavir for 48 weeks, had a 1.89 log average reduction out of a possible 2.42 logs. Efavirenz, produced by DuPont Merck, is a non-nucleoside reverse transcriptase inhibitor that is effective against many HIV variants and resistance also develops slowly. Data from another study on efavirenz will be reported at the Sixth European Conference on Clinical Aspects and Treatment of HIV Infection, October 11-15 in Hamburg, Germany. The additional number that is used to report viral load measurements is explained.
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PMID:Efavirenz (SUSTIVA, formerly DMP-266) 48-week data announced. 1136 90

DuPont Merck and Gilead Sciences are finalizing a program to make their new, experimental anti-HIV drugs available free to people who are not benefiting from other treatments. Enrollment information is included. The program includes the drugs DMP-266 and adefovir dipivoxil, and is a model for how drug companies can work together effectively to make experimental treatments available through expanded access programs. Initially, DMP-266 enrollment will be limited to 2,000 people with CD4 counts below 50 who are failing their current regimen. Adefovir will be available to 1,000 patients with CD4 counts below 50 and viral loads above 30,000. DMP-266 is a non-nucleoside reverse transcriptase inhibitor that is only taken once a day and shows great promise when used in combination with indinavir. Adefovir belongs to the nucleotide analog reverse transcriptase inhibitor class, and shows a unique resistance profile. It is also taken only once a day.
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PMID:DMP-266 and adefovir dipivoxil: 2 new AIDS drugs available to patients without treatment options. 1136 9

DuPont Merck is opening an expanded access program for efavirenz (Sustiva), a non-nucleoside reverse transcriptase inhibitor (NNRTI). Efavirenz (formerly called DMP-266), the most potent NNRTI to date, is taken only once a day. To participate, patients must be failing therapy or be intolerant of current therapy. The patients are required to take the drug with another anti-HIV drug that they have never taken. Contact information for efavirenz studies, including a pediatric trial, is provided.
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PMID:DMP 266 (Sustiva) expanded access. 1136 50

Although there have been great strides in AIDS research, there is no major development on the horizon that is capturing the attention of the press. However, there are significant developments being made in a number of areas. Current antiretroviral treatments are leading to declines in AIDS deaths and infections in the United States and studies are leading to a greater understanding of treatment failures and the role of compliance and adherence. Three new antiretrovirals are available in expanded access programs: abacavir (1592), efavirenz (Sustiva, DMP-266), and adefovir dipivoxil (Preveon, bis-POM PMEA). New treatment approaches will deal with restoring immune function, using vaccines to prevent HIV and opportunistic infection, and developing more antiretrovirals to combat the disease. The role of managed care and providing treatment to the uninsured and underinsured are also issues to be addressed in the coming year.
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PMID:1998 outlook: treatment; research; access. 1136 51

As many as 25 to 45 percent of patients using triple therapy with protease inhibitors will develop resistance due to a change in the genetic HIV code. However, patients who develop resistance may still benefit clinically when protease inhibitors are used in combination with other antiretrovirals. These patients may not have undetectable viral loads although they may have stable T4-cell counts. Resistance does not always lead to disease progression. Newer drugs under development or available through compassionate track programs may benefit people with resistance. DMP-266 (Sustiva) is a non-nucleoside reverse transcriptase inhibitor that shows promise for these patients. Other drugs in development include Compound 141, 1592, and adefovir.
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PMID:Understanding and managing resistance. 1136 97

Some of the latest developments in HIV treatment are described and contact information is given for people seeking further information on the topic. Clinical studies and preliminary results for interleukin-2 (IL-2), 1592U89 (abacavir), DMP-266 (efavirenz or Sustiva), and 141W94 (VX-94, Vertex) are described. Pharmaceutical companies are expected to continue developing new HIV drugs, including those in new drug classes, that will be more convenient, palatable, and less prone to resistance.
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PMID:What's new and what's next. 1136 53


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