March 26, 2012
The new Quad pill keeps HIV under control as well as Atripla (Sustiva + Viread) in one study, and in another performs as well as boosted Reyataz. Compared to Atripla, the Quad showed fewer neurological side effects. It's very likely this new pill could be FDA approved before the end of 2012.
The Quad pill is a combination of the new integrase inhibitor elvitegravir with the new boosting drug cobisistat plus Viread (tenofovir and emtricitabine). A total of 700 people who were starting their first regimen enrolled in the study. Only 10% were women. CD4 counts averaged 385 cells, while 30% were below 350 and 13% had fewer than 200. 33% of the study participants had viral loads above 100,000.
One-half of the people took the Quad pill while the other half took Atripla. At 48 weeks, about equal results showed that 88% on the Quad and 84% on Atripla had undetectable viral loads (<50 copies). However, those who started treatment with >350 CD4s did better on the Quad (91% vs. 84%). Those who started with viral loads above 100,000, 84% on the Quad and 82% on Atripla had undetectable HIV. As to increasing CD4 counts, people on the Quad gained 239 CD4s vs. 206 CD4s on Atripla.
As for side effects, more people on the Quad pill experienced nausea (21% vs. 14%). However, fewer people on the Quad experienced insomnia (9% vs. 14%), abnormal dreams (15% vs. 27%), skin rash (6% vs. 12%) and dizziness (7% vs. 24%).
A second study compared the Quad pill against boosted Reyataz (atazanavir/r) + Viread, a first-line regimen recommended by the federal Guidelines. The results showed equal suppression of HIV after 48 weeks of taking the regimens.
Again, about 700 people who were going on their first regimens participated in this study. Starting CD4 counts and viral loads were similar to the other study. At 48 weeks, 90% of those taking the Quad had undetectable viral load vs. 87% on Reyataz. Similar gains in CD4 counts were also noted, at 207 cells on the Quad and 211 on Reyataz.
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