The development of AIDS drugs is one of the hottest areas in medicine right now. Therapeutic vaccines, gene therapy, drugs that target HIV reservoirs, etc., are exciting to hear about. But, to be honest, these are somewhat distant, at least without a timeline for clinical use. But the following drugs, especially the first three, are close at hand. We Chinese patients may still be far away, but it’s always good to have hope.
1, TAF, full name tenofovir elaphene fumarate, Gilead research and development products, once a day oral 10 mg can, unlike TDF with 300 mg, low plasma concentration, so the impact on the kidneys and bones is small, used to replace TDF. but this drug is not listed alone, but as a compound, four in one or two in one, there are three: four in one pill EVG / cobi/TAF/FTC (can replace Stribild, expected to be marketed in the U.S. this November), two-in-one pill TAF/FTC (instead of Shufa Tai, expected to be marketed in the U.S. next April), and four-in-one pill DRV/cobi/TAF/FTC (Phase II clinical trial being done, not sure when it will be marketed).
2, DOR, full name Dorivirine, Merck R & D products, once daily oral 100 mg, instead of efavirenz, currently doing phase III clinical trials, preliminary results show that adverse reactions than efavirenz less, but insomnia seems to be more, not yet conclusive.
3, CAB, full name Cabotegravir), belongs to the integrase inhibitor, can be taken orally or by intramuscular or subcutaneous injection. Its structure is similar to DTG (Dolutegravir), an integrase inhibitor marketed in 2014, but the half-life is longer, with injections made with nanotechnology having a half-life of 21-50 days, which makes it possible to use it every month or even once every three months. Phase II clinical studies are underway comparing the efficacy and safety of intramuscular CAB (combined with long-acting Rilpivirine) every month, every three months and daily oral CAB combined with abacavir/lamivudine.
4. Fostemsavir, an entry inhibitor, is a Bristol-Myers Squibb product developed to prevent HIV from entering human CD4 cells by binding to GP120 on the surface of HIV and preventing the virus from binding to CD4 cells. Currently doing phase II clinical trials, are combined with Axent and tenofovir application.
BMS-955176 is a maturation inhibitor that prevents new HIV from maturing during the replication cycle in human CD4 cells. It was developed by Bristol-Myers Squibb and is currently in phase II clinical trials.