When will Raltegravir be available for fist timers?

[Miss Philicia]

the following if from the Poz Health Digest that I receive daily via email and may be of interest to those of you that are treatment naive, though I would assume that you'd need a more "progressive" HIV specialist to agree to go this route.  Personally I would consider it if it was me making this decision.  I believe if you wish to receive these bulletins you can send an email to: mailto:PozHealth@yahoogroups.com

ps:  Raltegravir is the same as Isentress, which is what I began 2 months ago -- seriously, it has NO side effects that I can tell.  Amazing and strong med.

When will Raltegravir be available for fist timers?
Posted by: "Jason Thomas" malebeyo@yahoo.com   malebeyo
Wed Jan 9, 2008 6:42 am (PST)

It looks like there already is 48 week data on it in treatment naive.
Is anyone here currently taking Raltegravir and what have been your
experiences with side effects and effectiveness of this med?

The integrase inhibitor raltegravir has impressive activity in
treatment-experienced patients (ACC May 7 2007) and, according to a
24-week analysis, may have similarly potent effects in patients who
are treatment naive (ACC Sep 18 2006). Now, 48-week results are
available from this same industry-sponsored study.

The trial involved 201 treatment-naive patients, including 30 who
participated in an initial 10-day study of raltegravir monotherapy (J
Acquir Immune Defic Syndr 2006; 43:509). All were randomized to
receive tenofovir and 3TC, plus either efavirenz or one of four doses
of raltegravir (100 mg, 200 mg, 400 mg, or 600 mg twice daily). Entry
criteria included a viral load ≥5000 copies/mL and a CD4 count ≥100
cells/mm3. At baseline, the mean viral load ranged across treatment
arms from 4.6 to 4.8 log copies/mL, and the mean CD4 count ranged from
271 to 338 cells/mm3.

By week 48, approximately 85% of patients in each group had achieved
viral loads <50 copies/mL. Viral loads became undetectable more
rapidly in patients who received raltegravir at any dose than in those
who received efavirenz (P<0.05). CD4-cell responses were similar among
treatment arms. Central nervous system side effects and lipid
elevations occurred more commonly in those who received efavirenz.
Virologic failure occurred in 3% of patients in each group; of the
five raltegravir recipients who experienced virologic failure, two had
viruses with the N155H amino acid substitution, a mutation known from
in vitro experiments to be selected by raltegravir.
Comment

These 48-week results confirm that raltegravir is likely to be at
least as potent as efavirenz when used in an initial regimen with two
NRTIs. The clinical relevance of the faster decline in viral load is
unclear, but the observation is certainly remarkable given that
efavirenz-based regimens induce a faster HIV RNA decline than do
regimens using boosted PIs. Although the authors speculate that
patients with raltegravir resistance might have maintained viral loads
below baseline because of a reduction in viral fitness due to
raltegravir-selected mutations, this phenomenon has previously been
well described with NRTI resistance, which was also present in these
patients. Given these impressive results overall, we eagerly
anticipate the findings of a larger, phase III study of raltegravir
versus efavirenz that is already fully enrolled. If that study yields
similarly favorable results, the decision about when to consider
raltegravir a first-line therapy option will be up to individual
clinicians, patients, and various guidelines committees, with the
major concern being the absence of long-term safety data.

[aztecan]

Oh, sorry, I read the thread title and thought you were getting kinky.

It was an interesting piece, though.

HUGS,

Mark

[allopathicholistic]

My doctor said he would prescribe Raltegravir if someone was having bad nausea from Lexiva and was okay with a twice-a-day regimen. Other than that he didnt say much else.