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The Body Covers: The 1st International AIDS Society Conference on HIV Pathogenesis and Treatment
Antiretroviral Therapy
July 9, 2001 This article is part of TheBody.com's archive. Because it contains information that may no longer be accurate, this article should only be considered a historical document. Click here to view the original abstract.
The long term one is to develop a new formulation of amprenavir that will decrease the number of pills required. The name of this new drug is GW433908. This is a prodrug of amprenavir that is more water soluble, which eliminates the need for the very complicated formulation that was the culprit of the very big pills. This new formulation can be packaged in 465mg tablets and data was presented during the last Retrovirus meeting in Chicago. The second one is to combine amprenavir with ritonavir. The use of concomitant ritonavir inhibits the p450 system and increases the level of amprenavir dramatically in patients that take these drugs in combination. The most frequent doses have been combining 600mg or 750mg of amprenavir with 100mg of ritonavir twice a day. In this study, data was presented on the 17 patients who began with the regular "old" dosing of 1,200mg amprenavir every 12 hours in combination with abacavir and 3TC as part of the antiretroviral-naive trial COL30325 that enrolled 38 patients. These seventeen patients switched to a boosted regimen with ritonavir after the initiation of the trial. There were no differences in the rates of virologic successes with the two schedules and the new regimen was better tolerated. Surprisingly this new regimen did not produce any significant changes in lipid or glucose parameters after the switch. Larger studies are needed to prove that amprenavir is a first-line-therapy protease inhibitor. I do not know if they will ever be done. In any case, it is important to remember that even with the boosted regimen we are still talking about seven pills twice a day, in an era of much simpler regimens out there for naive individuals. The simplest one of them involves one tablet of Trizivir twice a day. It is for this reason that I think amprenavir will continue to be used mainly after virologic failure with another protease inhibitor. In that setting it is an especially useful drug. For the future of amprenavir, I personally like more the new formulation approach. What makes amprenavir attractive is its lipid "friendliness," a unique feature among the currently available protease inhibitors. This lack of lipid abnormalities is somewhat lost, or at least compromised, when you combine this drug with ritonavir. In the setting of deep salvage therapy, when potency is the main concern, the use of "boosted" regimens seems less problematic. In my practice, we tend to combine amprenavir with Kaletra for the rescue of patients with multiple protease inhibitor failure because it is usually the protease inhibitor that maintains some residual activity and it does seem to work in that clinical situation.
This article is part of TheBody.com's archive. Because it contains information that may no longer be accurate, this article should only be considered a historical document.
This article was provided by The Body PRO. Copyright © Body Health Resources Corporation. All rights reserved.
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