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scary thought. what is really the deal?
Jan 2, 2004

Dr. Dave,

It seems that hiv therapy works two fold: (1) patients wait for some good news about new medicines that are approved without the side effects and resistance problems, but nothing happens. (2) new meds but should be more described as reformulated meds are introduced after many years of research as Agenerase Pro and Zerit XR but these still have the same side effects.

Where are the new, less problematic drugs that many of us need? What agents are these. Yes, we are looking for drug names here. Thank you.


Response from Dr. Wohl

Dear Calvin,

You are right. Many 'new' HIV drugs are me-too agents that offer only a bit more than their predecessors. But, there are a few new drugs that are making a difference. We should not take for granted the impact tenofovir has had over the past 2 years. It has really helped usher once a day therapy from a concept to a reality. More recently, atazanavir, has surprised many by its popularity. Again, it is once a day and unlike sister protease inhibitors it also has negligible metabolic effects.

Further, anyone who has benefited from T-20 as part of salvage therapy will attest to this drug's value. Also, I'd mention the rehabilitation of ddI which went from a nasty almost cruelly disgusting formulation to a sleek once a day capsule that has really done some heavy lifting lately.

In the pipeline are going to be drugs that help fill niches including agents that are active against resistant virus. Tipranavir will help many with protease inhibitor resistance. Drugs for efavirenz/nevirapine resistant virus are in high demand and many are working on such medications.

Therefore, mixed in with the reformulated oldies are some new therapies that are helping people. Obviously we still need better, safer and cheaper therapies. DW

a disgraceful lack of knowledge (and with no excuse)
HIV-ITP and initial regime

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