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Biotech / Medical : Agouron Pharmaceuticals (AGPH) -- Ignore unavailable to you. Want to Upgrade?

To: Henry Niman who wrote (4628)	6/30/1998 11:43:00 AM
From: Joe E.	Read Replies (1) \| Respond to of 6136

Henry: I don't think this has been studied extensively with patients, but I think there is a lingering belief that patients who develop resistance to Viracept are somewhat more likely to retain their ability to benefit from other protease inhibitors. I think that the belief that Viracept is a superior salvage therapy for other protease inhibitors is disproved. The benefit is believed to come when Viracept is used first. I was expecting something on this out of this Geneva conference. Henry, you did write a lot about resistance in the last few years, but as you say the phenomenon was very well known. With reports of treatment failure rates of 50% in some patient groups, and maybe 25% even under the best circumstances, I continue to think that protease inhibitors will be used in most patients for perhaps the next decade or so. Even those who start with another treatment will likely move to protease inhibitors when/if the first treatment fails. And of course most patients will start with PI's in their drug cocktails for the next several years as this is the one procedure that is known to work best. The ability to routinely investigate the resistance profile of the virus infecting an individual patient is on the way, and will lead to a new standard of treatment, one more designed for the individual patient. This will encourage use of the full cocktail for each patient, as the lab report will so recommend. Fewer patients will be started on a subset of the full cocktail, as it appears happens today. I do see some market share and price implications for Viracept, in a few years, depending upon the approval timing and pricing of Sustiva. Also, it appears that the Vertex/Glaxo PI is being pushed back further, and now seems unlikely to have a major impact in the near future.

To: Henry Niman who wrote (4628)	6/30/1998 5:10:00 PM
From: Joe E.	Respond to of 6136

Henry: further regarding salvage from protease inhibitor resistance: healthcg.com The above is kind of a summary article, and further has this summary paragraph: "What are we to make of these studies? Together they suggest that it may be possible to sequence protease inhibitors (especially if the primary failure is with nelfinavir) but the odds are greatly improved if the switch is done early (when the viral load is still relatively low, such as below 5,000-10,000 copies/ml). " I was hoping for more patients in the studies, though.