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I am scared that companies are dropping new HIV medications
Jun 17, 2010

Nelson, I emailed you before and you told me there were a few medications in research for people with resistance to all meds. But I just heard that two companies abandoned their research. What does that mean for someone like me who is waiting for new medications? I am so concerned.

Response from Mr. Vergel

Yes, I am also concerned about what is happening to drug development and its implications for those of use who are living with 3 or 4 medication class resistance who are waiting for more options. There is a belief that everyone treated with HAART has undetectable viral load, and only those who do not adhere to medications are the ones failing HIV therapy. I hear this a lot coming from doctors and researchers in meetings. People in salvage therapy have become the silent minority and if we do not speak up, our lives will be at risk. Salvage therapy advocacy is almost non-existent in this country, so we need to work together to remind companies that we are still here, and that new medications to treat new HIV targets are needed.

Several small companies working in HIV are running out of money since investors do not see HIV as a money making disease anymore.

An Australian company called AVEXA abandoned its apricitabine (a new nucleoside inhibitor) after spending years and millions on its development since their board does not think they can make money in HIV anymore (read the link "Avexa closes apricitabine program" here : http://www.avexa.com.au/news). Their drug could have helped some of us with Epivir/Emtriva resistance. A few activists and myself have sent the company a letter to ask them to reconsider their decision. I am still hopeful.

MYRIAD, a company in Utah, also abandoned their maturation inhibitor this month. The drug has had a lot of ups and downs. It may only work in 50% of naive patients and it may not work in patients like you and me who have multidrug resistance since we may have gag mutations that render this drug ineffective. So, I am not sure I blame them for putting their efforts somewhere else, but still think that other maturation inhibitors should still be explored.

GSK-ViiV is testing two second generation integrase inhibitors in people like you and me who have failed raltegravir. But it is too early to tell if this drug will help us. We will know by early 2011.

TAIMED, a Taiwanese company, have the only drug in a new class which can help people in salvage. The company is small and having problems finding sponsors that would fund their phase III study. Of course, like any new drug, it requires at least one other active medication in combination with it for it to work. But I am hopeful that its drug (ibalizumab, a CD4 monoclonal antibody provided every two weeks) combined with other drugs like GSK's integrase or non nucleoside could help us if found to work after the current studies are done.

PROGENICS (http://www.progenics.com/prod_pro140.cfm ), also a small company, also has a drug in a new class but in early stages of development (PRO 140, an entry inhibitor). I certainly hope they do not follow AVEXA and MYRIAD !

KORONIS ( http://www.koronispharma.com/KP1461forHIV.html ) also has a very interesting drug that makes the HIV develop mutations that may make it weaker when exposed to HIV medications, but the research on this drug has a long way to go before we think it can help people in salvage.

Hang in there and try to remain as stable as you can while you wait for options. Make sure that you and your doctor find the best "holding pattern" HIV regimen for you as you also take prophylaxis for PCP, herpes, and other potential OIs and co-factors that may affect your health.

Stay tuned. I am still hopeful, but I also need to do a lot of work n activism to ensure that small companies have the support they need from the FDA and community while they search for funding to get their drugs approved. At the same time, we must closely follow the work being done in immune based gene therapies that may provide another avenue to survival to some of us.

Please touch base with me periodically so that I can keep you abreast of new developments in the search for new drugs to help people in salvage therapy.

Nelson



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