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Two New CCR5 Inhibitors, Actually 3
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Hi from CROI in Boston 2008
Jules Levin
On the eve of the NY Gianys first Super Bowl win in years I bring you the first report from CROI. Today in the conference press meeting researchers presented on two Schering CCR5 inhibitors. Schering has a new CCR5 inhibitor (SCH532706) and data is being presented here from a 15-day monotherapy study in 12 ART naive and experienced patients. Viral load was reduced by an average of -1.62 log, and no safety concerns were reported. As well, Barry Zingman, a Giants fan from the Bronx, reported 48 week results from VICTOR-E1, a phase 2 study looking at 2 doses, 20 and 30 mg of vicriviroc i patients with experience in 3 HIV classes of drugs. Baseline CD4s were 200 and HIV RNA was 4.5 log. Average viral load reduction was -1.75 log and about 55% had <50 copies/ml. Pfizer is reporting here new study results on a new CCR5 antagonist. It is too soon to tell but there is some hope that perhaps both new CCR5 antagonists won't be completely cross-resistant with their cousins vicriviroc or maraviroc.
Several additional CCR5 antagonists including the Incyte drug will be presented here in osters. So, development of CCR5 anatagonists is an ongoing story.
There are interesting updates here on darunavir, the new NNRTI TMC-125 etravirine, an Abbott study comparing once vs twice daily Kaletra, the CASTLE study comparing Reyataz to Kaletra, the HEAT Study looking at abacavir vs tenofovir, an update on 48 weeks with Merck integrase raltegravir in treatment-experienced patients, and there are poster sessions on lipodystrophy, heart disease, renal disease and bone disease. There are presentations here on the new enhanced Monogram CCR5 tropism assay
There was a meeting here today by INSIGHT to discuss planning for the global study of when to begin HAART, I think ts called START. I discussed with several researchers the importance of including bone disease evaluations and there appear to be several researchers trying to convince the NIH & DAIDS to integrate this important question into the study which will include looking at other non-AIDS conditions and diseases. There is a poster here reporting bone disease in 67% of HIV+ individuals in the study and the average age was I recall 40-something, 54% had osteopenia and 13% osteoporosis. There is a second study in premenopausal women finding that hiv-positive women had lower bone mineral density than hiv-negative women, and the average age of the women was 41. The reason I mention age is because in the HIV-negative world bone disease and fractures only become great concerns in older ages 60-70 yrs. Its about time bone disease gets addressed: education & research.
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