Henry: re your question about relative results of different protease inhibitors as backup therapy when another protease inhibitor fails.
I predict you will still have the same question after your read this note, but here is my recollection from the reporting on the studies presented in Toronto:
If Viracept is used first, then fails, a large fraction (but less than half) of patients respond strongly to subsequent treatment with another PI. There is some question about whether the response is long lasting, but it lasted for the duration of the small trial.
If another PI (was it Crixivan?) is used first, then fails, almost all patients fail the subsequent treatment except for a short response period. A few do not fail, though, which is good.
IMO, the reports I have seen do NOT suggest that Viracept is especially good as a backup PI therapy. Viracept is IMO thought to be good as a primary PI therapy, partially because if it fails there is a better chance of a backup PI therapy working.
All of the studies are small, so the statistical validity is not there yet, and the initial conclusions could even be completely backward. However, IMO the reports of the in vitro results support the conclusions mentioned above. |
