David, I found the 1 July research note you refer to by Jay B. Silverman (Robertson, Stevens & Co.). I hope the following portion of Mr. Silverman's report will bring a discussion on it's validity. I request anyone who disagrees with his reasons reference the appropriate source:
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"1. Summary of data presented at AIDS Resistance Workshop consistent with our Viracept stance. A variety of data was presented at the International Workshop On HIV Drug Resistence, Treatment Strategies and Eradication conference (June 25-28, St. Petersburg, FL) on all AIDS drugs, including protease inhibitors.
a. Chief Virologist at AGPH shows Viracept helps patients that have failed all protease inhibitors. In a study presented by Dr. Amy Patick of Agouron, 39% of patients (25/64) who failed protease inhibitors responded to treatment with Viracept. The same was shown in a laboratory study of resistant isolates, samples treated once again given Viracept were responsive to the drug. Both of these support first-line therapy of Viracept.
b. Patients who fail viracept can be teated with other protease inhibitors. Investigators also showed that patients that have failed Viracept (and like any protease inhibitor, some do), can be treated effectively with other protease inhibitors, in this case Merk's Crixivan. This study also supports Viracept as first-line therapy.
c. Protease-protease resistance possible with mutation at position 90 also bodes well for AGPH. Another theme in the abstracts throughout the meeting is that it is possible for patients to become resistant to all protease inhibitors if they have a mutation at position 90 in the virus. Once again, this supports first line therapy for either Viracept (and/or Crixivan).
d. In sum, protease inhibitors are likely to lead to some percentage of resistance, but Viracept and Crixivan stand out as best choices; based on regimen/safety, we choose Viracept. This was a four day meeting to discuss resistence and as such, resistance examples were given for all AIDS drugs, including protease inhibitors. That is not new. However, the incremental data continues to support Viracept as first-line therapy, and hence, market share data does, too (see below)"
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IMO, Mr. Silverman is one of the best Biotech analyst in the business.
I also have had the opportunity to talk to Dr. Patick several months ago, a very impressive person, who is a recognized leader in the field.
What would you do if someone you loved tested HIV positive? Would you really want them to start to take Crixivan instead of Viracept in their prescribed combo? |
