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Tibotec compounds
Mar 23, 2004

Do you have any information on the state of play with respect to TMC125 and TMC114 - my understanding is that clinical data so far have been very impressive. I am yet to commence HAART and am keen to hold out for the best available compounds - on this front is there any available data yet on a regimen combining Viread and Emtriva as opposed to Combivir. I would like to avoid Combivir if at all possible since I understand the side effects can be quite severe. However, if the Tibotec compounds are as powerful as I have been led to believe is their efficacy likely to be compromised in any way if I were to switch later??

Thanks, Nat.

Response from Dr. Pierone

There are no data yet that I am aware of on the status of Combivir vs. Viread/Emtriva. Studies are underway and reports will eventually be forthcoming. To some degree, they will already be outdated when they are presented since we are moving towards once daily therapy. The real question is going to be the comparison of Ziagen/Epivir combined tablet vs Viread/Emtriva combined tablet as nuke backbone. Glaxo presented a study at ICAAC several months ago comparing Ziagen/Epiver to Combivir (all received Sustiva) and they were essentially equivalent. Less of a CD4 count increase with Combivir was noted, probably due to bone marrow toxicity of AZT component of Combivir.

TMC 125 is a promising agent, but appears to be stymied in development, not sure why. TMC 114 is in phase 2 of development and will be targeted for those with multi-drug resistant virus. Since you are nave to therapy, these compounds are not even on the radar screen. With good adherence, the first regimen that you start should last many years. We all have many patients with excellent adherence that have not developed one bit of resistance to therapy.



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