An ongoing dialogue on HIV/AIDS, infectious diseases,
June 16th, 2010
Another HIV Drug Development Program Bows Out
Last month, Avexa announced that they will not be going forward with their development of the investigational NRTI apricitabine.
Now Myriad says its program to develop bevirimat is closing as well.
The problems with these drugs — twice daily dosing with apricitabine, formulation and mixed responses with bevirimat — are not the real story here, since arguably we have overcome these hurdles with investigational drugs before.
Nope, the real issue here is that the challenge of HIV drug development has become staggeringly high due to the very success of our current therapies. Who wants to spend the resources on therapies for drug resistance when hardly anyone fails treatment anymore?
Which leaves me wondering: what are we going to do with that small population of patients who have literally no drug options? The group with NRTI, NNRTI, PI, enfuvirtide, and integrase resistance who have dual-mixed tropic virus?
Time for “orphan drug” status for investigational HIV drugs that meet this need? Certainly some sort a national collaborative effort would be welcome, as most practices have very few of these unfortunate patients.
Patients who have no drugs options slowly beginning to emerge in our routine. They certainly need investment in research of new molecules.
But currently, one of the most common cause of this phenomenon is a inadequate choice of the new treatment regimen in patients with prior triple-class(NRTI, NNRTI and PI) failure and resistance.
I think that the better way to avoid this complex situation, is necessary effort to always include three fully active drugs in the salvage therapy regimens.
What you think about it?