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