What's New in Treatment Information?
from the Information Department of Project Inform
According to the Access Project, the only HIV drug that is in expanded access currently is atazanavir (Zrivada). T-20 is in open label trials (a type of drug trial in which researchers and participants know who is taking the experimental drug or treatment being given), which can be easily confused with expanded access programs (programs designed to make experimental drugs available on a wide basis to people who do not qualify for the drug trials or who live too far from a trial site). According to our IA department, T-20 should be coming out in expanded access sometime after mid-July.
For more information on the atazanavir expanded access program, check out the Access Project website at www.atdn.org/access/index.html and click on the Expanded/ Early Access Programs link.
The drug valganciclovir which is used to treat the symptoms of cytomegalovirus (CMV) retinitis -- an infection in the eyes associated with HIV -- has been successfully added to the ADAP Formulary!!
Although valganciclovir will not cure CMV, it may help to keep the symptoms such as floaters (small spots in the vision), decreased visual activity loss of peripheral vision, blurred vision and blind spots from becoming worse. Please note that many people with CMV retinitis have no symptoms.
There are some side effects such as black, tarry stools; blood in urine or stools; chills; cough; fever; hoarseness; lower back or side pain; painful or difficult urination; pale skin; pinpoint red spots on skin; sore throat; seeing flashes or sparks of light; seeing floating spots before the eyes; troubled breathing; ulcers, sores, or white spots in the mouth; unusual bleeding or bruising; unusual tiredness or weakness; veil or curtain appearing across part of vision and less common such as changes in facial skin color; fast or irregular breathing; hives, itching, and skin rash; large, hive-like swellings on eyelids, face, lips, mouth, and/or tongue; puffiness or swelling of the eyelids or around the eyes; runny or stuffy nose; shortness of breath; tightness in chest and/or wheezing. These side effects may arise for a person taking valganciclovir so as always encourage the caller to talk to their doctor about any and all changes or difficulties.
Organon, the company that makes the anabolic steroid deca-durabolin (Nandrolone), halted the manufacturing of the product in early June. The Food and Drug Administration approved the decision. People using deca-durabolin can expect difficulty getting it, if they have not already experienced it. When pharmacies run out, no replacement is expected. Also, generic products are not available to serve public programs, like ADAPs.
Organon sites extensive off label use of deca-durabolin as the reason for stopping the manufacturing. Off label use is when a therapy is being used for conditions for which it has not been FDA-approved. For example, this therapy is not approved for treating HIV-related weight loss, but many people with HIV use deca-durabolin off label for treating the condition.
A number of therapies are approved for treating HIV-related weight loss. They include:
Because of the drawbacks of other strategies for treating wasting syndrome, testosterone-like therapies have become popular. Hospital and HMO administrators readily approve and encourage physicians and patients to explore the off label use of products like deca-durabolin, because they save costs. Many living with HIV prefer to use testosterone and similar products because they have somewhat fewer side effects and perhaps more desirable or workable side effects than megesterol and growth hormone. Other products are available, such as testosterone creams and patches and other anabolic drugs.
Deca-durabolin is a testosterone-like product, but it's not testosterone. It is a preferred treatment for women, as it doesn't have the degree of virilizing effects as other products, which means the degree to which it promotes developing secondary male sex characteristics. It does, however, in both men and women, interfere with the body's ability to naturally produce testosterone.
There is rumor that a compounding pharmacy has secured a minimal generic supply of deca-durabolin. It is unclear how long their supplies will last. They can be reached at www.gulfsouthrx.com/HIV.htm or 877-729-1015.
Clearly this is not the most desirable means for long-term access. Activists are working on this issue, and undoubtedly more information will be available as the story unfolds. For more information on HIV-related weight loss and developing a weight maintenance strategy, contact Project Inform's hotline.
For John James' AIDS Treatment News article on the supply problem with the anabolic agent, nandrolone, click here.
Back to the What's New? August 2002 Table of Contents.
This article was provided by Project Inform. It is a part of the publication What's New. Visit Project Inform's website to find out more about their activities, publications and services.