Agouron, Bristol Myers, Others Aim to Set Their HIV Drugs Apart
Bloomberg News
September 25, 1998, 5:19 p.m. ET
Agouron, Bristol Myers, Others Aim to Set Their HIV Drugs Apart
San Diego, Sept. 25 (Bloomberg) -- As potential combinations
of AIDS drugs reach mindboggling complexity, drugmakers are
arming themselves with arsenals of studies to try to distinguish
their treatments from the rest.
Today, at a massive infectious disease conference in San
Diego, Bristol-Myers Squibb Co. and Agouron Pharmaceuticals Inc.
benefited from studies showing their drugs may need to be taken
less often than others, such as Merck and Co.'s Crixivan, in the
powerful protease inhibitor class.
''We're excited,'' said Richard Colonno, who leads research
into new drugs for infectious disease at Bristol-Myers, the
second largest U.S. drugmaker by sales. Bristol-Myers'
experimental treatment ''has the potential to be a once-a-day
drug,'' he said.
Bristol Myers shares rose 11/16 to close at 100 5/8, while
Merck fell 5 5/8 to 131 1/2. Agouron shares fell 1/4 to 32 3/8.
While Agouron's Viracept has been on the market for well
over a year, Bristol-Myers is only in early stages of testing its
new drug. The fact that it's already boasting about a potentially
easier dosing regimen is a sign of the complexity of AIDS
treatment and the competition in a drug market that IMS Health
projects will reach $2 billion this year in the U.S. alone.
AIDS doctors must weigh the benefits of powerful drugs such
as the protease inhibitors sold by Agouron and Merck & Co.
against the side effects they carry and the risk that
inconvenient drug regimens will cause patients to skip doses. Too
many missed doses means patients can develop HIV mutations and
ending up with a drug-resistant virus.
Sustiva's Rapid Acceptance
The problem has led to rapid acceptance of DuPont Co.'s
recently approved drug, Sustiva. While not a protease inhibitor,
the drug has been shown to be powerful and is the first approved
AIDS medication that can be taken just once a day. DuPont has
shipped more than 90,000 bottles of the drug in its first week.
''Clearly, there's still a need to have newer and better
drugs for HIV,'' said David Cooper, a leading AIDS specialist
from Sydney, Australia. DuPont's Sustiva and new drugs close to
market developed by Glaxo Wellcome Plc, Vertex Pharmaceuticals
Inc. and Gilead Sciences Inc. ''will provide useful additions,''
he said.
Other new drugs and all-new approaches may offer even more
hope, experts said. Some of those drugs, including ones under
development at Triangle Pharmaceuticals Inc., Warner-Lambert Co.,
Abbott Laboratories, Trimeris Inc. and Pharmacia & Upjohn Inc.
were highlighted in a session last night at the Interscience
Conference on Antimicrobial Agents and Chemotherapy held this
year in San Diego.
Still, the really new approaches are likely several years
away, and doctors must cope with what they have now.
Risk of 'Squandering' Drugs
Choosing which drugs to use first is important. If a
combination doesn't work, a patient's virus may be resistant not
only to the drugs in the original combination but to others as
well. The problem is especially evident among protease
inhibitors.
''We've really got to be careful not to squander the great
drugs that we have,'' Cooper said.
For companies, that means proving to doctors with studies
that their drug is the best option for a newly diagnosed patient.
A spate of such studies will appear at ICAAC over the next
few days. It also means looking for continued research that
promotes the idea of early treatment.
In a ''viewpoint'' in a recent edition of the prestigious
U.K. medical journal, the Lancet, AIDS researcher Jay Levy
questioned the ''hit early'' approach. Levy, of the University of
California at San Francisco, claimed that doctors are being too
aggressive and treating patients who may be better served by
waiting until their immune systems can't handle HIV on their own.
Drawbacks
His argument hinged in part on the drawbacks of powerful
drug combinations, which are becoming more obvious. Several
studies to be presented at ICAAC detail what researchers believe
are metabolic side effects of the protease inhibitor drugs,
causing problems ranging from bizarre humps of fat to an
increased risk of diabetes.
There is some debate about whether the side effects are
caused by protease inhibitors alone or whether they are caused by
an interaction of drugs, by the rapid reduction of HIV or perhaps
even by other drugs taken in combination with the protease
inhibitors. The effects appeared after the advent of protease
inhibitors, also sold by Roche Holding AG and Abbott
Laboratories, but the protease inhibitors for the first time also
allowed patients to see dramatic reductions in HIV and, in some
cases, to come back literally from the brink of death.
On the other side of the fence are scientists led by Bruce
Walker of Massachusetts General Hospital who have done research
showing that hitting the virus earlier with aggressive regimens
means the immune system will sustain less damage and will be more
likely to be able to fight HIV.
''It just depends on where the balance of the tradeoff is,''
Cooper said. ''That question obviously has to be answered.''
--Kristin Jensen and Kerry Dooley in San Diego through the |
