Merck Integrase Inhibitor MK-0518 Thoughts?

[David84]

I am exploring options with doctor about MK-0518 to add to my dwindling list of treatment options. Is anyone on the limited access program with Merck? Thoughts, feelings, suggestions? Been doing my homework, so would appreciate other viewpoints.

Thanks and Hugs.
David

PS.  Going outside for a bit to enjoy this BEAUTIFUL Autumn afternoon!!!

[MSPspud]

Hi David -

While I don't know anyone on this drug, my doctor is particularly excited about it's development and the preliminary results.  He feels relatively confident that it will be the most viable replacement of my 4 drug combo, in an effort to reduce toxicity.  Out of the other investigational candidates, this drug does not require ritonavir boosting!  If you can get into a limited access program - great; however, my doc felt it would be available for expanded access very shortly (if you can hold out a few more months).

Jason

[jjmcm]

David, I currently do not qualify for the Merck-0518 EAP because for the first time in ten years I am undetectable after hitting the virus with Kaletra (125% normal dose), Invirase, Combivir and Fuzeon.  Of course, like everyone I know on it, I HATE Fuzeon, but love being undetectable.

My doctor and I have talked extensively about Merck-0518 and GS-9137.  I have a friend on Merck-0518 with TMC 114 (Prezista) and he went undetectable for the first time ever and his CD4s have doubled.  It also did it very quickly, in less than a month.

My current plan is to stay on this regimen until mid next year when I understand Merck-0518 will hopefully be approved.  By then, it is likely that we will know how it works with TMC 125, the NNRTI being tested my Tibotec.  If everything goes as planned, I would like to do TMC114, TMC 125, and Merck-0518 with maybe keeping a NRTI combo pill in the background.  This would allow me to go back to completely oral meds again which would definitely have me celebrating.

I guess you know that Merck-0518 does not require Norvir boosting like GS-9137.  It is also taken once per day.  The Merck-0518 benefits because it does not have to run through the CYP3A4 pathway in the liver.

What is your current regimen, labs?  Have you used Fuzeon yet?

--JJ

[Christine]

Hi David,
I have talked with my doctor about both the GS, and the Merck drug. Both were favorable discussions. I started in the GS study because it was available sooner in my area. So far though, I was randomized to the non-drug arm, so I won't actually start the med until late October.

I will let you know how it works for me.
Christine

[David84]

Hey All:
Got some good news today!  Viral load down to 715 (lowest in 4 years.. down from 65,000)   cd4 up to 58 and 4% cd4!! Small gains but good news none the less.

We talked about MK-0518 and he (dr.) is also investigating Pfizer. From what I understand Merck has less side effects etc. So he wants to deliberate a bit more before making a decision. Regardless, I am optimistic and will look to make some decisions the end of this month. Until then the regime remains:
Fuzeon (since '03), Aptivus, Norvir, Zerit ,Viread and Mepron ... and the litany of others to manage all the other joys that coexist. Anyhow, I am excited about the future and thank you for your input... will keep you posted

Film at 11!! 

Hugs
David