Stribild (the Quad) Approved in Canada
November 28, 2012
On November 26, 2012, Health Canada licensed the sale and use of a new combination of anti-HIV drugs in one pill. This combination has been nicknamed the Quad and will be sold under the brand name Stribild. The combination is a complete treatment regimen; such combinations are called single tablet regimens (STR). Stribild is approved for the treatment of people new to HIV therapy (treatment naive). Stribild is made by the pharmaceutical company Gilead Sciences.
Stribild is already licensed in the U.S. and approval is pending in the European Union and Australia.
Inside the Quad
The Quad contains four medicines, two of which are new, as follows:
The Quad also contains two older anti-HIV medicines that belong to the class commonly called nukes (nucleoside analogues):
Stribild is taken once daily with food.
In clinical trials with treatment-naive HIV-positive people, the Quad has been very effective in reducing the amount of HIV in the blood (viral load) and raising levels of CD4+ T-cells. Together these changes have resulted in improved health. Researchers have found the Quad to be roughly equivalent in effectiveness to another already licensed STR called Atripla, which consists of a fixed-dose combination of the following drugs:
In HIV-positive people who are treatment experienced, researchers found the Quad to be roughly equivalent to a commonly used regimen consisting of the following anti-HIV drugs:
In clinical trials, Stribild was generally safe and effective. However, as with any regimen, there are some issues users should be aware of, including the following:
The most common side effects associated with Stribild were nausea and diarrhea. A link to further information about possible side effects and more detailed information from clinical trials appears toward the end of this bulletin.
Kidney and Liver Concerns
Stribild should not be taken by people who have a moderate (or worse) degree of kidney dysfunction. The manufacturer specifies that this refers to people who have an eGFR (estimated glomerular filtration rate) of less than 70. Also, people who have severe liver damage (having Child-Pugh rating of class C) should not use Stribild.
The drugs in Stribild, particularly elvitegravir and cobicistat, have the potential to interact with many other drugs and herbs. Always speak to your doctor, nurse and pharmacist about taking other drugs (both prescription and over the counter), supplements or herbs if you are taking Stribild or other anti-HIV medicines.
A drug interaction may do the following:
AIDS Healthcare Foundation Challenges Gilead Over AIDS Drug Price Gouging of U.S. Government Programs on Stribild
This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
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