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

To: Izzy who wrote (4739)	7/5/1998 8:56:00 PM
From: Izzy	Respond to of 6136

SI IMNR post #782 provides helpful reading references.

To: Izzy who wrote (4739)	7/5/1998 9:45:00 PM
From: nord	Read Replies (1) \| Respond to of 6136

from s San Francisco to Geneva Alot has happened in the last year regarding therapy controversies re availability, best drugs, timing of drugs, vaccines. I remember back in the early 80's while an infectious disease fellow hearing about this strange clustering of PCP in gay men. Now we have a world wide epidemic much as I had feared. The drug industry the world health organization and the medical community have watched tried at times to intervene, educate, but it is hard to change human behavior particularly sexual behavior. In the meantime things moved slowly the identification of the virus. the mechanisms of immune system depletion the early therapies. Fast forward. Coming away from the current meeting pessimism has swept the community. The reality is there is no cure for HIV. Vaccines appear at best years off. For those already infected they face a death sentence. To those not yet infected we hold out the hope that they can over come their local customs sexual morees and not infect others. I am not optimistic. For those recently infected there is hope based on the work of Ho and others we understand the kinetics of HIV: billions virions produced daily for years. Since the advent of HAART I have seen some amazing clinical responses some short lived some more durable. Going forward we now have a large stable of available drugs and more on the way. Realitiies of treatment are that to take IMO optimal therapy requires Money Motivation and Monitoring the three MMM"S For clinic patients in the industrialized world this means finding new money to treat those patients who have two of the three MM's. For the patient who has the three M's what is optimal therapy. I don't know. Our group has participated in the dmp 266 trials and I am impressed with Sustiva If I had to decide what was optimal therapy based on all available data I would take as many potent drugs as my mind, wallet, and gastointestinal system would allow. Protease sparing is like saying don't give the most effective combo's available. It's cheaper and easier to take an PI sparing regimen, but is it as good. I don't think so. Time will tell. For now for naiive s dual PI /nnrti/ and one or two nuc's is still the way to go. The idea that a patient has thousands of genetically different strains of virus, that HIV is a highly mutagenic virus and that billions of new virions a day are reproduced all suggest that hit em early long and hard is the way to decrease the number of circulating virus and G-d willing is the way to decrease total viral load[per person] thereby decreasing the number of different strains in circulation and available for future mutation. If you cut back on therapy to early viral loads rebound. The optimum therapy is the therapy in that patient that they can tolerates and that hits the virus in as many locations as possible.ie is durable. Afterall the goal of therapy should be to to let patients live with AIDS not die from it. RE. AGPH viracept has been a great drug as seen by its marketshare despite a small but growing marketing team. As the company was a one drug company with great science x ray crystallography platform and a new subsidiary that can rapidly screen drug candidates. Seems to me that for a small price the company has greatly accelerated it's pipeline with PI's new potential for immune enhancement and that for a fraction of the traditional development cost the co. has new therapy candiddates that if and that is a big ig they will have new drugs to sell through there new marketing forces. Afterall why did these other companies choose to partner with AGPH. AGPH is small nimble aggressive and has good scientist and now marketing to go with it, I think the company is being treated poorly by the street misunderstood by investors and will continue to suprise on the upside with earnings growth viracept market share growth. Remember once the nnrti resistance develops it is a class resistance, Many of the long term HIV patients are getting virammune a nnrti as salvage and i am sad to say most of them the additive effect of virammune is short lived. The bottom line a year from now optimal therapy for naiive Hiv will be IMO 2 PI a NNRTI and 1 or 2 nucs. Good luck to all those living with and those treating HIV. In the meantime i am glad that AGPH is out there looking into and marketing new combinations that will be durable well into the next generation of drugs until we lick this plague Norden