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Biotech / Medical : Agouron Pharmaceuticals (AGPH)
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To: scaram(o)uche who wrote (4592)6/30/1998 6:45:00 AM
From: Henry Niman  Read Replies (2) of 6136
 
Rick, I asked some questions about PI resistance awhile ago because thestreet.com had issued a report indicating that Viracept resistance did not necessarily result in a mutation that would still be responsive to subsequent treatment with other PIs and this board had been discussing resistance patterns for ages (although no one seemed to be able to directly address my questions). I had dropped in for some clarification because I had thought that it's unique resistance patterns was one of Viracept's major advantages.

I agree that my comments on resistance in general were not novel, but John W seemed to think that PI's would "cure" AIDS or at least offer long term benefits and he quoted some AIDS researchers. I said that they were overly optimistic and that resistance would create some major problems down the road and some of the promising results were due in part to an insensitive assay (below detection of 500 copies /ml wasn't anything close to eradication, which has been borne out with assays that detect 50 copies/ml or 5 copies/ml).

I think that the data being presented at this time reinforces my earlier comments.

I certainly not saying that AIDS patients do not benefit from PIs. However, the benefits are not as durable as some on this board seem to think, and there are complications such as lipodystrophy and other metabolic disorders.

My comment of resistance was a general one. It seems that an increase in viral load in patients taking three drugs would indicate that emerging strains would be resistant to all three drugs. There isn't all that much info on the resistant strains, but it seems likely that they will be more difficult to treat, as more established drugs lose their effectiveness.
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