The world of HIV medicine is an ever changing place, particularly when it comes to the medication that we need to take to keep us healthy.
Inside your clinic will likely be a team of HIV research nurses and doctors working hard to get you access to the latest treatments out there even before they are licensed and available. These research drugs are exciting; they’ve been tested rigorously before hitting research clinics but still require large published studies before becoming commercially available.
Working in HIV research gives me a great insight into treatment options coming in the near (or distant) future, and having HIV myself, I find it comforting to know that newer treatments are coming out every year which will keep us all ticking along quite nicely!
So what exciting drugs are in the pipeline?
So the “QUAD” pill talked about for so long is finally here (with its silly American name). It has its EU licence so it should pop up in your clinic in the upcoming months. It’s a combination of 3 drugs and a booster in one pill. The benefits are that it doesn’t have the central nervous system side effects like ATRIPLA can (the crazy dreams etc) but like all meds can give you a dodgy tummy if you don’t take it with food.
This integrase inhibitor is soon to be upon us, having been trialled throughout the world over the last few years and recently received its American license (Europe shouldn’t be far off). It’s the first once daily integrase inhibitor in a single small pill. The only other integrase inhibitor on the market is Raltegravir – which has to be taken twice a day. Having a once daily integrase inhibitor means adherence should be better and this class of drug is known for crashing your viral load to undetectable super quick! Even more exciting is the ongoing trial where its mixed with Kivexa into one pill meaning another Single Combination Pill is on the way.
Tonofovir Alfenamide Fumerate (TAF)
This is an updated version of the well used NRTI drug Tenofovir Disoproxyl Fumerate currently found in Truvada, Atripla, Eviplera, Stribild and Viread. In a nutshell, they have changed the salt that the drug is attached to which allows it to be given in much smaller doses. The initial data is promising and the hope is that there will be less side effects and smaller pills which leads on to the next exciting drug in progress…
DRV/COBI/FTC/TAF (still to be named)
For people out there on PI based regimes, the years of 3 or 4 pills a day are hopefully coming to an end. Gilead (the drug company behind Atripla, Eviplera, Stribild & Truvada) has teamed up with Jannsen (the makers of Darunavir) to investigate the first Single Combination Pill to include a PI. This in itself is thanks to the discovery of TAF which helps to make this new pill small enough that you could swallow it. It’s still a lot of drug into one tablet so it will be interesting to see how small they can get it. It’s still a few years off but exciting nonetheless.
This means we now have three Single Combination Pills on the shelves in our pharmacies, ATRIPLA, EVIPLERA and STRIBILD and we should have another couple coming in the not-so-distant future. This all adds to an ever growing portfolio of drugs which ultimately means more choice for us – the patients.
Barts Health NHS Trust