Subject: NEW AIDS DRUG SAQUINAVIR: SCI INFO
From: Jim Brudner <[email-masked]>
Date: 11 Nov 1995 22:41:58 GMT

Saquinavir (SQV), whose approval was recommended the 
other day by an FDA advisory panel, is the 1st of a series of HIV 
antivirals that target the enzyme protease.  All previous 
approved antivirals have targeted another enzyme, reverse 
transcriptase (RT).  This is a major advance in HIV therapy.  
	SQV is not a perfect drug.  It must be used in 
combination with an RT inhibitor like AZT, DDC or D4T.  The dose 
recommended by the panel appears to be way too low (higher doses 
of 3600 to 7200 are being tested and may prove superior), and the 
t cell increases at the recommended dose avg. only 30 - 40. Other 
protease drugs coming down the pike, like one from Abbottt Labs, 
have demonstrated 100 t cell increases.  
	However, for people whose bodies have used up the 
benefits of standard antivirals, and whose immune systems are 
crashing, protease inhibitors could be a godsend.  They could be 
a stopgap for the next six months to a year while the other 
better drugs come down the pike, The danger is that the
drug will engender cross-resistance against the later more 
powerful drugs.  A report in the September 1995 September 1995 
edition of GMHC Treatment Issues, however (p.6-7) downplays this 
possibility:  "Genetic analysis of over 1,500 individual viral 
samples from...patients [who had taken saquinavir either alone or 
in combination with AZT or AZT and DDC] could discover no HIV 
that after exposure to SQV was cross-resistant to other protease 
inhibitors.   

-- 
Jim ([email-masked])