Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
November 26, 2014, 12:29:21 AM

Login with username, password and session length


Members
Stats
  • Total Posts: 647445
  • Total Topics: 49334
  • Online Today: 170
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online
Users: 6
Guests: 123
Total: 129

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Starting treatment: Quad Pill?  (Read 5587 times)

0 Members and 1 Guest are viewing this topic.

Offline newhorizon80

  • Member
  • Posts: 37
Starting treatment: Quad Pill?
« on: August 23, 2010, 12:06:18 AM »

My doctor believes that I would be a great candidate for the Phase-III drug study for Gilead's Quad-pill and I told him that I wanted to research it before making any decisions.  I think I may end up enrolling in the study from my readings so far, but was wondering if there was anyone else on it?  If so, how has it been going so far?
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline Zohar

  • Member
  • Posts: 249
Re: Starting treatment: Quad Pill?
« Reply #1 on: August 24, 2010, 04:22:41 AM »
Which drugs are combined in this quad pill?
''Poor is the man whose pleasures depend on the permission of another.''

Offline Miss Philicia

  • Member
  • Posts: 24,422
  • celebrity poster, faker & poser
Re: Starting treatment: Quad Pill?
« Reply #2 on: August 24, 2010, 08:06:19 AM »
It contains the new integrase inhibitor elvitegravir, the new boosting agent cobicistat, as well as tenofovir and emtricitabine (the components of Truvada).

Basically it's similar to a regimen of isentress and truvada, but for some reason the new integrase inhibitor needs a boosting agent like that with protease inhibitors and norvir.

My physician is the medical director of the largest HIV clinic in Philadelphia, and the clinic runs trial studies so he has many patients already on this and he told me during my visit last month that it's performing very well. I personally would not hesitate to go on this if I had the opportunity.

From what I've read as of Phase 2 this quad pill met the criteria for non-inferiority to Atripla, with less adverse side effects, particularly CNS ones.
"Iíve slept with enough men to know that Iím not gay"

Offline newhorizon80

  • Member
  • Posts: 37
Re: Starting treatment: Quad Pill?
« Reply #3 on: August 24, 2010, 02:51:04 PM »

Thank you for the reply.  I've been on the fence about starting treatment and my Doctor has been supportive on my decision, but I told him over the course of our visits that if I fall below 400 (my personal limit), then I'm ready.  So, here we are (last CD4 was 350).

I'm leaning towards enrolling in the initial study (have to pass their requirements first)-- I just didn't want to say yes without at least knowing about it versus walking in and reading it all fresh.
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Re: Starting treatment: Quad Pill?
« Reply #4 on: August 24, 2010, 04:06:37 PM »
Some things to bear in mind:

The study is likely to be randomised, so you might not get the Quad pill. If it is randomised you will get a real (standard of care) and dummy set of pills or the new drug and a dummy set of pills. It could mean taking a lot of pills (well 2 actually, cos the standard of care is likely to be Atripla). Are you up for this? Are you up for possibly taking Atripla? Your doc should be able to tell you what the standard of care alternative is.

Virologically, the new Quad pill seems good so far. When Quad was compared to Atripla (efavirenz + tenofovir + FTC), over 80% of patients in each group had undetectable viral load (less than 50 copies/mL) after 24 weeks. This is a good result.

In the Phase 2 study, patients in the Quad group (48 people) became undetectable more quickly than those on Atripla (23). After 8 weeks, about 80% people were undetectable with Quad compared to about 50% with Atripla. But baseline viral load was generally modest, less than 40,000 copies. It was only over 100,000 copies in 25% of patients. If you have a high viral load (100,00+), maybe something known to work with high viral loads would be of greater benefit to you?

Quad was better tolerated in terms of not having efavirenz-related side effects (dreams, sleep disturbance etc), but there is caution on the impact of cobicistat (the new booster and Norvir alternative) on reducing estimated glomerular filtration rate (eGFR ie kidney function). This suggests that Quad may not be a good choice if you have a poor kidney function to start. Side effects from Quad are as yet unknown in full. Would you prefer something more tried and tested?

Taking antacids reduces elvitegravir (they key new drug in Quad) concentrations by about 50%. Separating antacids from Quad by 2 hours decreases elvitegravir concentrations by 10-20%. Elvitegravir concentrations are unchanged if separated by 4 hours. If you need to take antacids this is something to bear in mind (cos taking Quad and antacids together may make the antiretrovirals ineffective).

Hope this helps

- matt


References:

http://i-base.info/htb-south/999
http://i-base.info/htb/2434
"The object is to be a well patient, not a good patient"

Offline mikey62

  • Member
  • Posts: 32
Re: Starting treatment: Quad Pill?
« Reply #5 on: August 27, 2010, 01:25:13 AM »
I also heard that Johnson & Johnson may be coming out with a new 3-in-1 (don't know the name at this point) pill in January, that doesn't contain Sustiva.  Is this similar to the Gilead?
Oct '07 - seroconverted (didn't know what it was at the time)
8/21/08 - tested HIV+
9/18/08 - CD4:329  21%  VL:7000
11/13/08 - CD4:415  19%  VL:5470
1/30/09 - CD4:109  18%  VL:5000 (bad lab count) THAT was scarey!
2/12/09 - CD4:389  19%  VL:5500 (re-tested)
4/15/09 - CD4:365  19%  VL:18,320  (due to slight infection)
5/30/09 - CD4:279  20%  VL:285K  time for meds (Atripla)
6/23/09 - CD4:264  20%  VL:683
9/25/09 - CD4:318  21%  VL:325
11/20/09 - CD4:330  24%  VL:123.  I'm gettin there...
1/15/10- CD4:337  24%  VL:118
2/26/10 - CD4:389  28%  VL:ud
6/25/10 - CD4:395  25%  VL:ud
8/24/10 - CD4:407  28%  VL:ud
1/14/11 - CD4:512  26%  VL:ud
6/09/11 - CD4:535  29%  VL:ud
4/02/13 - CD4:605  32%  VL:ud
6/14/13 - CD4:470  29%  VL:ud

Offline markdown

  • Member
  • Posts: 13
Re: Starting treatment: Quad Pill?
« Reply #6 on: September 11, 2010, 02:31:31 PM »
I am in the quad pill study. I started almost 2 months ago (in fact, Monday 9/13 will be my 8 week checkup). You will have to take 2 pills a day: one in the morning with food which is the quad pill or a placebo and one pill in the evening on an empty stomach which is Atripla or a placebo.

I had great results at my 4 week checkup: viral load went from 110,00 to undetectable and my cd4 went from 157 to 214. I am experiencing no side effects so far. I suspect that I am taking the quad pill.

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Starting treatment: Quad Pill?
« Reply #7 on: September 11, 2010, 03:10:44 PM »
Hi Mark, welcome to the forums. (glad we finally got you sorted!)

Those results and the lack of side-effects are remarkable. I'm not on meds yet and at the moment, my first choice would be Reyataz + Norvir + Truvada (when the time comes). When Isentress gets approved for once daily dosing, that and Truvada will be my first choice.

However, my doc (who is also an hiv pharmacologist) is very excited with the results thus far of the Quad studies and I suspect that will become my first choice when it becomes approved for treatment naive people.

So I'm looking forward to hearing updates from you about the Quad. The fact that you've been on it for two months now with no side effects is very encouraging and yes, it sounds to me also that you're likely to be on the Quad instead of the Atripla. It seems that people who start Atripla with numbers like yours experience at least some mild side effects for the first few weeks.

Keep us posted, please.

Ann


edited because I said weeks when I meant months. ::)
« Last Edit: September 11, 2010, 03:18:38 PM by Ann »
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Hellraiser

  • Member
  • Posts: 4,140
  • Semi-misanthropic
Re: Starting treatment: Quad Pill?
« Reply #8 on: September 11, 2010, 03:31:35 PM »
I've never heard of anyone taking Atripla without getting the "Head Rush" where your head feels heated not long after taking the pill.  If you're not getting this side then you're definitely not on Atripla.  At least as far as I'm concerned.

Offline newbieguy

  • Member
  • Posts: 197
Re: Starting treatment: Quad Pill?
« Reply #9 on: September 11, 2010, 08:48:45 PM »
I've never heard of anyone taking Atripla without getting the "Head Rush" where your head feels heated not long after taking the pill.  If you're not getting this side then you're definitely not on Atripla.  At least as far as I'm concerned.

I definately got the hot-sensation head rush my second night on Atripla. It was weird and kinda unnerving, but haven't noticed anything like it since then.

Offline Hellraiser

  • Member
  • Posts: 4,140
  • Semi-misanthropic
Re: Starting treatment: Quad Pill?
« Reply #10 on: September 12, 2010, 02:11:08 AM »
I definately got the hot-sensation head rush my second night on Atripla. It was weird and kinda unnerving, but haven't noticed anything like it since then.

Do you go to bed immediately?  It takes an hour or two to hit you.

Offline Inchlingblue

  • Member
  • Posts: 3,119
  • Chad Ochocinco PETA Ad

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Starting treatment: Quad Pill?
« Reply #12 on: September 14, 2010, 07:25:15 AM »
Good news, yes, but I'm a little disappointed in the size of the cohort.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline markdown

  • Member
  • Posts: 13
Re: Starting treatment: Quad Pill?
« Reply #13 on: September 16, 2010, 06:52:13 AM »
Ann, would you explain what you mean by "the size of the cohort"? Thanks.

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Starting treatment: Quad Pill?
« Reply #14 on: September 16, 2010, 07:29:09 AM »
Sometimes a small study involving a mere hundred patients shows good results and, all of the sudden, this med becomes instantly popular (see QUAD), at the expense of the 'older' ones.

My Doc said that 30 MILLIONS of people are (or have) taking Viramune, daily, for years (it has saved millions of lives). If it were THAT bad it would show!

I thought that comment made a LOT of SENSE. A hell lot of sense...

He also cited some med that was very popular at one time until they found out , later, that is promotes cancer. This med had been removed. He gave me a name I (obviously) did not know.

Cheers

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Starting treatment: Quad Pill?
« Reply #15 on: September 17, 2010, 10:52:07 AM »

Ann, would you explain what you mean by "the size of the cohort"? Thanks.

The size of the cohort = the size of the group of people studied. :)
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline markdown

  • Member
  • Posts: 13
Re: Starting treatment: Quad Pill?
« Reply #16 on: September 20, 2010, 05:21:37 PM »
Just got my 8 week labwork results back: viral load undetectable and cd4 rose from 214 to 359! I am so pleased right now.

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Starting treatment: Quad Pill?
« Reply #17 on: September 20, 2010, 05:33:23 PM »
Wow, that means you've actually gone 157 to 359 in the space of eight short weeks. Great news!

Still no side effects?

I hope you're on the Quad - if you are, it sounds like a great combo.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline markdown

  • Member
  • Posts: 13
Re: Starting treatment: Quad Pill?
« Reply #18 on: September 20, 2010, 06:03:06 PM »
Hey Ann,
   Yes--still no major side effects. The only thing I've noticed is that I tend to burp in the morning more than I used to. This is another reason I believe I'm on the Quad--because I take that pill in the morning.

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Starting treatment: Quad Pill?
« Reply #19 on: September 20, 2010, 06:25:44 PM »
Oh yes, definitely. I can't see them telling you to take Atripla in the morning. Good news! Thanks for keeping us updated.

Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline newbieguy

  • Member
  • Posts: 197
Re: Starting treatment: Quad Pill?
« Reply #20 on: September 22, 2010, 11:17:42 PM »
When I met with my doctor today, we discussed the Quad and the exciting possibility of it being available by possibly next year or if it becomes approved. Another once-daily option is definately good, and just one more treatment option in general (and hopefully easier) for people!

Offline newhorizon80

  • Member
  • Posts: 37
Re: Starting treatment: Quad Pill?
« Reply #21 on: October 08, 2010, 11:47:26 PM »
Hi Everyone,
Just an update from my original post: I had gone in to see my DR., and I was quite surprised that the study was going in involve four pills (study: GS-US-216-0114), he mentioned the original study he was going to have me look into was no longer open (also was four pills).

It will be a randomized, double-blind comparing:
GS-9350 + atazanavir + emtricitabine/tenofovir DF: Experimental
ritonavir + atazanavir + emtricitabine/tenofovir DF: Active Comparator

After an hour+ session of reading and talking to the study coordinator, I asked for my DR to come in and I think I was just scared to finally start (the realiity of starting, etc.), I was offered Atripla, but my main concern is that if I have side effects it may affect my performance at work (given that I sometimes work afternoons and then also early mornings (4 a.m.), so if I'm taking Atripla at night, getting up at 2 a.m. my be a little hard. 

My next, baseline, appointment is October 19.

10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.