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How good is this new hiv drug ???
Jan 23, 2009

Hi Dr Keith, how good is this new hiv drug ???? thank you for your time Ross

Panacos Pharmaceuticals announced yesterday that it has sold its first-in-class HIV maturation inhibitor bevirimat to Myriad Genetics, a biotechnology company that is also developing maturation inhibitors.

Maturation inhibitors block HIV replication by inhibiting a pathway essential for the assembly of a mature, infectious virus. Instead, non-infectious viruses are produced, preventing subsequent cycles of HIV infection.

Panacos will receive $7 million for bevirimat, which may provide a useful cash injection for the company and allow it to continue work on second- and third-generation maturation inhibitors that are easier to formulate and active in a wider population of people with HIV.

Bevirimat has been beset with problems during its long development history, due both to difficulties with the formulation and also the discovery that the drug lacks activity in people with polymorphisms (natural variations) in HIVs gag gene that may be more common in treatment-experienced patients.

In October 2008 Panacos reported results from a phase II study which showed bevirimat oral solution was effective in treatment-experienced people who lacked gag polymorphisms. However, the company still faced the challenge of developing a tablet formulation.

Panacoss decision to sell the drug comes as little surprise; treatment activists have previously expressed doubts about the companys ability to bring the drug to market.

Whats more surprising is that the company has found a buyer; as the Treatment Action Group noted in its 2008 Pipeline report [the fact] that no big pharmaceutical partner has appeared to take bevirimat forward means that most of them had a look at the drug and decided to pass.

The buyer, Myriad Genetics, already has experience of bringing cancer drugs to market and is developing its own maturation inhibitor, MPC-9055 (also known as Vivecon), which is due to enter a phase IIA dose-ranging study shortly. This study will identify the dose to be carried forward in development.

Myriad Genetics says that it has another maturation inhibitor in preclinical development, and is also working on a HIV fusion inhibitor.

Panacos meanwhile says that it has identified second-generation maturation inhibitors with better bioavailability and the ability to overcome gag polymorphisms, which it hopes to test in humans soon. The company has also identified a third-generation maturation inhibitor that is chemically distinct from bevirimat, raising the prospect that it will be active against viruses resistant to bevirimat. Panacos is also attempting to develop an oral fusion inhibitor. The only fusion inhibitor so far licensed, enfuvirtide (Fuzeon), must be injected twice a day

Response from Dr. Henry

Bevirimat has shown moderate activity for the treatment of HIV infection including for virus which is resistant to the current HIV meds. Development is still early. For most HIV practices in US the currently HIV medications are usually working well. The role of a new drug like bevirimat is uncertain at this point due to limited data and at least in our practice there is not a major need at the moment for another new drug due to the effectiveness of current drugs. It is important to keep developing drugs with new mechanisms of action in order to offer treatment options for persons with highly resistant virus or other problems (tolerability) with current drugs so I am anxious to see more data on the maturation inhibitor class. KH



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