Apr 16, 2002
Dr. Young: Hello. With HARRT trotting along at 6 years now, there must be data collected to show which meds are more potent than others. Therefore, will some of the present meds fall to the wayside and be replaced by more potent ones? Steve
Response from Dr. Young
There are only limited numbers of studies that compare different treatments against one another-- most of these studies show equivalence between approaches, though some do show superiority of one drug to another (for example, the recent Abbott clinical trial that compared Kaletra (a boosted PI) to nelfinavir (an unboosted PI).
What seems to be the case is that performance of medications is very intimately linked to the ability of the study population to be adherent to the treatment regimen for a long time-- hence differences in drug regimen performance might simply reflect differences in long-term adherence or tolerability more than intrinsic differences in potency.
What this means in practice is that we try very hard to tailor treatment choices to individual needs (ie, low pill counts, dosing frequency, side effect profiles)..
I believe that we will have a day when we will have simple, potent and well tolerated regimens; this day may soon be here, we don't yet have the long-term, prospective clinical trial data to prove the concept. Stay tuned. BY
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