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New class of HIV inhibitor launched in UK

The first in a new class of antiretroviral treatments, integrase inhibitors, has been launched in the UK yesterday (January 23).

The first in a new class of antiretroviral treatments, integrase inhibitors, has been launched in the UK yesterday (January 23). 

Merck Sharpe and Dohme's drug Isentress (raltegravir) is approved for use in combination with other antiretroviral medicinal products for the treatment of HIV-1 infection in treatment-experienced adult patients with evidence of HIV-1 replication despite ongoing antiretroviral therapy. 

Isentress is the first antiretroviral treatment to target the integrase enzyme. Integrase is one of three HIV enzymes required by the HIV virus in order to replicate (reproduce); the other two enzymes being reverse transcriptase and protease. Integrase is responsible for inserting (integrating) the viral DNA into the DNA of the host cell. By preventing this essential function, an integrase inhibitor affects the ability of the virus to replicate and thus can help to prevent infection of other cells, and to reduce the viral load - the amount of virus present in the blood.

"HIV is a clever virus that adapts and mutates quickly, producing drug resistant strains of the virus. The more ways we have to attack the virus, the more chance we have of successfully managing the disease. But we've got to be smart about how we use these new drugs; we don't want to repeat past mistakes where resistance arose from using single therapies. When used as part of individually tailored combination therapy, raltegravir will be an important step forward in our fight against HIV," said Dr Mark Nelson, director of HIV services, Chelsea and Westminster Hospital, London. 

The late stage therapy market has, until recently, been dominated by Roche's drug Fuzeon, which had been the only entry inhibitor to be approved. However, that changed with new classes of drugs being  approved, such as Pfizer's CCR5 inhibitor Celsentri (maraviroc) in 2007, and now Isentress. 

Both Isentress and Celsentri are more patient-friendly drugs than Fuzeon; Fuzeon has to be injected twice daily and can cause injection-site reactions. Both Celsentri and Isentress are taken orally.  

According to Datamonitor, the HIV market is forecast to grow from USD7.1bn in 2005 to around USD10.6bn in 2015.

23rd January 2008

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