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Author Topic: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)  (Read 5275 times)

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Offline newt

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Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« on: December 06, 2011, 04:24:52 pm »
I am posting this here (though happy to see it moved) cos it seems a common question these days, Isentress vs Sustiva (and therefore Atripla)?

New data shows Isentress gives superior results compared to Sustiva over 4 years, reported here:

http://i-base.info/htb/15961

Typically +60 CD4 count and considerably less side effects.

If only Isentress were 1 x day like Sustiva.

This will make for interesting conversations in the UK with drug purchasers....

- matt
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"The object is to be a well patient, not a good patient"

Offline buginme2

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #1 on: December 06, 2011, 08:32:41 pm »
I wonder how Elvitegravir will compare, it would be nice to have the efficacy and side effect profile in a once a day option. 
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Offline AverageJoe

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #2 on: December 06, 2011, 09:45:15 pm »
I would like to have this as a treatment option when the time comes for me to start taking medicines.

I'm a little confused as to whether this would be an option for me due to some resistance in my strain of HIV.
My consultant says I have resistance so cannot take Atripla, instead she has offered reyataz or darunavir plus Truvada and Norvir. So I assume I have resistance to the sustiva portion of Atripla.

Does it sound like Isentresss would be an option for me?

I really must speak to my consultant and get clear information regarding my resistance at my next appt in February.

It's great to know that newer drugs are continuing to improve in efficacy and side effect profile.
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Offline newt

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #3 on: December 08, 2011, 05:08:27 pm »
If you have resistance to Atripla but are being offered Truvada, yes it is likely to be the efavirenz portion of this combo (and therefore also you will have resistance to nevirapine). If you are being offered atazanavir or darunavir your doc must judge you have no resistance to these. Isentress resistance pre-treatment is currently uncommon, so this is prob also an option (if you can get it).

Good you's gonna ask your doc, he/she will be able to say which drugs are in/out the frame resistance wise. Worth understanding this menu it is. Drug choice really does depend on what your resistance test says.

- matt
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Offline madbrain

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #4 on: December 08, 2011, 05:40:42 pm »
I take the Isentress 1x a day (2 pills) at the same time as my Truvada, in the evening. It has worked for me. I don't think I am the only one.

Too bad the studies on once a day Isentress were aborted.
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Offline TonyDewitt

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #5 on: December 21, 2011, 05:51:55 pm »
Too bad everyone didn't have your fantastic numbers! Did your fatigue resolve?
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Offline NycJoe

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #6 on: December 21, 2011, 06:06:43 pm »
I would loooove to change from Atripla.  I will ask my Dr about it.
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Offline Since2005

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #7 on: December 28, 2011, 12:25:38 am »
Quote from: NycJoe on December 21, 2011, 06:06:43 pm
I would loooove to change from Atripla.  I will ask my Dr about it.

Why do you think you want to change from Atripla? Do you mind to share?

It seems like people who may have problems with Atripla due to sustiva portion of it, Isentress would be the next best option for them?

Its good to know that it's 'uncommon' for having 'resistance issues'  for this combo. Wish that if it came with 'once a day' option. Is there any chances / studies shows to make a once a day option anytime soon? Any talk/ researches?

Since ( Who feels so lucky sometimes to be able to choose from different options from today's meds - hypothetically speaking since he hasn't done his resistance testing yet..)
« Last Edit: December 28, 2011, 02:21:48 am by Since2005 »
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Offline Ann

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #8 on: December 28, 2011, 05:10:19 am »
Ooops, I thought I moved this thread to the Treatments forum when it first appeared. Guess I didn't.

People wanting to know about treatments will find it easier to find what they're looking for when treatment information is posted in the Treatment forum. (did that make sense? I need more coffee....)

 
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Offline eric48

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #9 on: December 29, 2011, 05:27:07 pm »
Quote from: newt on December 06, 2011, 04:24:52 pm
...If only Isentress were 1 x day like Sustiva.
This will make for interesting conversations in the UK with drug purchasers....
- matt[/font]

Interesting info. Thanks!

It was not a 'recommended' (If my recollection is correct) regimen for treatment in EU guidelines
when I considered meds. It was already at the 'recommended' status in the US

The EU guidelines have been updated and now include RAL in the 'recommended' list (similar, the, to the US)

http://www.europeanaidsclinicalsociety.org/index.php?option=com_content&view=article&id=59&Itemid=41

The EU Guidelines is one thing, local insurance regulations is another. Where I live, RAL TDF/FTC will still be covered by social security as a second line and not yet as a first line

This regimen was among my 'preferred' list, but since it required special approval by insurance doctors we opted out (I had already one count of possible exclusion from insurance coverage since my Nadir was 440 and current 510).

I still keep an eye on it, especially elvitegravir or dolutegravir and others still in the pipeline as one of them may be once daily.

Now that I an on a once daily dosing (after 6 months on BD) I must admit  had initially undervalued the benefits. I fact, it really makes my life easier.

I was really upset when I learned that RAL TDF/FTC could not be an option for me due to gvt red tape.

Even, if I may not go for it ultimately I will be happy when our socialized health care announces that it can cover this combo for naives.

seeing some progress on that front makes me feel better about that initial frustration

Thanks again for the news

Eric
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Offline madbrain

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Re: Choosing meds..Isentress achieves superiority over Sustiva (but still a 2 x day)
« Reply #10 on: January 09, 2012, 11:33:53 pm »
Quote from: TonyDewitt on December 21, 2011, 05:51:55 pm
Too bad everyone didn't have your fantastic numbers! Did your fatigue resolve?

Yes, for the most part it has. I am not sure HIV was the only cause, though. I was subsequently diagnosed with sleep apnea which also plays a part.
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