Cocktail aid

An exorbitant wonder 'double-drug' developed for improving survival chances from AIDS may elude needy patients in Africa and Asia

Published: Tuesday 31 October 1995

-- RESEARCHERS are now preparing a Unique"cocktail" to cure those unfortunate me ones stricken by the deathly dis, AIDS. Scientists working with the Vju' scheme, sponsored by medical 0stch agencies in Australia and 7 mpean countries - Britain, Ireland, pice, Germany, Italy, the Netherlands d Switzerland - have come up with pdmmry thatmiKing 2 or 3 AIDS drugs adininister a "combination treat-ment" significantly reduces deaths from the syndrome.

"The pessimistic view t the virus is totally year" is not true. i can improve survival and that is good iL Tbe view that combining drop together is NS io be better than Wdiam alone, is also ffmoviL' declared a Gerrard, principal is of the study p b attached to the 1W Research Council is Srbija, while presenting bis papers at the opriaii Aws conference in Copenhagen ISemebeF 26, 1995.

arriou"ement was hailed by liodostry, especially by the main ift the Manufacturing of AIDS-resistant druge. The best known among up is zidovudine or AZT. The no" firm Wellcome, which Plim taken over by Glaxo, had Pilau= thebasis of an experimental anti-cancer drug, in 1985. Patient greeted its launch in 1987 as the mW Aws drug, although they daboat its exorbitant price. AZT &W a peak of us $347.2 million 6 mW then began to fall as orm about its side effects and aflongterm effectiveness. The w was the result of a study conducted jointly in England and France in 1993, which showed that AZT had actually failed to prevent thousands of healthy Hiv-positive people from developing AIDS.

For the last 2 years, Gazzard and his colleagues have been conducting trial tests on more than 3,000 Hiv-positive men and women under the Delta scheme. Thestrategywiis to tryout drug combinations. The Delta tests involved 3 possibilities: treatment with AZT alone; with AZT plus didanosine I or DDI manufactured by Bristol Myers Squibb; and AZT plus zalcitabine or Doc, which is produced by Roche. Delta studied these combination particular because DD1 and DI)c happened to be the first anti-Hiv drugs developed after AZT. All 3 are in the same pharmaceutical category; they work by jamming a viral enzyme known as reverse transcriptase, which enables Hiv to replicate itself. Out of the 3,000 patients who underwent the tests, 1,000 had already taken AZT for at least 3 months and 2,000 had received no previous treatment at all. And they were assigned at random into the 3 treatment groups.

Among those previously untreated, 17 per cent who took AZT alone died during the trial, compared Nyith 10 per cent of the patients who took AZT Plus DD 1, and 12 per cent who took AZT with DDC. Unfortunately, the Delta results showed no clear benefit in switching to a combination treatment for patients who were already taking AZT. Rates of death and illness among the 1,000 participants previously on AZT monotherapy were the same, whether or not assigned to a combination treatment later.

The results were so dear that the international coordinating committee of the Delta decided to stop the trials in mid-September before the scheduled time period was over. It went ahead and released "the preliminary results as they have important implications for people with Hiv infection and their doctors".

Needless to say, pharmaceutical giants are now dreaming of mega bucks; espececially Glaxo. The company lost no time in pushing for an improved "reverse transcriptase inhibitor" with fewer side effects called the 3TC. This drug was discovered by the Biochem firm of Canada, but then bought off by Glaxo. Glaxo is now trying to flex its strong marketing muscles in order to prove that AZT Plus 3Tc is the most effective alternative among the various cocktails suggested for AIDS cure. Already having astronomical shares, if it succeeds in its endeavour, the company would have the market under its wings.

The treatment would, of course, be expensive. Patients would have to shell out a fantastic us $7,000 a year to pay for the double-drugs. And, patients lan guishing in Asia and Africa - the most needy ones - would definitely have a very poor access to this treatment.

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