Shaking the Status Quo: 2012 HIV/AIDS Conference Research Highlights

Antiretrovirals in Development

As soon as the approval of the long-awaited "quad" (elvitegravir/cobicistat/emtricitabine/tenofovir, Stribild) added a valuable new integrase inhibitor and boosting agent (as well as a new efavirenz [Sustiva, Stocrin] alternative) to the first-line therapy pantheon, eyes almost immediately turned to seek out the next exciting drug in the antiretroviral pipeline.

It didn't take long for those eyes to settle on dolutegravir, an integrase inhibitor whose safety and efficacy profile impressed in early clinical trials.

In a series of phase 3 studies presented or published throughout the year (including at the International AIDS Conference and ICAAC), dolutegravir continued to shine, sporting treatment response levels similar to or greater than that of a number of standard-of-care regimens.

The bar continues to climb for HIV antiretrovirals, with expected efficacy rates for first-line regimens now nearing the 90% mark -- a level almost unthinkable less than a decade ago. And yet the pipeline, while arguably not as rich as it was several years ago, continues to feature promising drugs, with dolutegravir as the present-day vanguard.