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Long acting meds in the pipeline?

Dec 23, 2006

Dr: Hello. Could you name a few for the long acting medicines that you medtioned in a prior posting.

Thanks for the service provided by yourself and the other doctors here. Lorcan in Ireland

Response from Dr. Pierone

Hello, and thanks for posting.

There are some long-acting medications in the pipeline. Roche may be trying to reformulate Fuzeon as a once a week medication. If this effort is successful it would represent a vast improvement over the twice daily injection which is currently used.

TNX-355 is a monoclonal antibody which has been in trials for quite a while and is administered by the intravenous route and has antiviral activity that persists for several weeks. PRO-140 is another monoclonal antibody with a prolonged action that is entering trials.

Some of the medications that we currently use actually have a very long half life, and could be dosed less frequently, but we don't use them this way currently. For example, Sustiva stays around in the bloodstream for over a week after the last dose. This prolonged persistence is probably one the reasons that resistance may be more likely to develop in the face of suboptimal adherence (since the half-lives of the nukes are shorter and effective monotherapy results). This may be less of an issue with Atripla or Truvada/Sustiva since Viread and Emtriva have a longer duration of action than older agents.

In any case, the improved pharmacokinetics of newer agents will hopefully translate into better clinical outcomes for people living with HIV infection.

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