A few thoughts regarding this confusion by the experts here on the thread.:
1) These new revelations certainly make the recently published NIH guidelines and the NEJM conclusions look foolish. I wonder how many of those experts that were responsible for either document are saying, "how could we have been so wrong?" A few very questionable studies change all the work and conclusions of both official guidelines and the NEJM article. Come on people, nothing has changed. Those studies are in fact positive for both MRK and AGPH and support the "hit hard and hit early" strategy. If the real world failure rate is so much higher (approx 50%) vice clinical trials (2 yr study with crix-approx 20%), then ask yourself why?
-- Is the possibility of resistance developing due to not following a strict dosing schedule. This just emphasizes the importance of the compliance issue-some doctors are reluctant from prescribing the cocktail because they feel that a particular patient may not be compliant and a particular point of the disease. The importance of compliance is nothing new and is more positive to a PI that has an easy dosing schedule and mild side effects. Ask yourself which PI you believe has the best side effect and dosing regimen.
---Was the poor showing in the "real world" study due to having developed resistance to previous treatments or having been previously heavily treated. Was it the possibility of having a high viral load before a triple combo was started with a PI. If this was a possible reason for the difference btwn the clinical studies and this real world study, doesn't this support the "hit hard and hit early" reasoning and evidence.
These are a few of the explanations for this contradictory study. think about it, this all bodes well for the future of Crix and Viracept.
2. Evidence presented by Agouron's study validates the in vitro claims of Viracept as the first line PI. The "late breaker" study validates the claim that the higher the viral load whether resistance has developed to any PI or not, the likelihood for success worsens for any treatment.
Hit hard and hit early with a smart combination that lends itself to compliance, durability, prolonged viral suppression, and allows the best chance for future treatment options if or when resistance develops to any one of the treatments. What treatment approach is best for a particular patient?
3. NOT A CONSPIRACY THEORY, however I was not that shocked to not see any major headlines on the draft guidelines released yesterday for the treatment of HIV infected children. These guidelines also came to the conclusion of starting the triple combination therapy early with a PI (I.e VIRACEPT or ritonavir). There is no coverage of this story or any of the extremely positive data released by AGPH. Why? By reading todays article in the alley.com, It implies that there are no less than 10 PIs on the mkt including ones from Triangle and Vertex.
4. What we are observing was the "noise" coming from ICAAC as one analyst suspected. When the sensationalism is over, after the shorts cover, the facts will be rediscovered.
5. Look at Crossens revisions for EPS-his numbers don't go down in the same magnitude as the dark possible future he portrays. He can hardly raise this quarters consensus as many analysts recently have. I am very confidant AGPH will exceed his current estimates on this quarter and prove his inability to estimate Viracept's sales a month in advance much less in 24 months in advance due to a single questionable study.
I enjoy all the personal attacks on me, they are an indication of desperation and usually predicts a move upward in AGPH's price. |
