依曲韦林(TMC-125):治疗 HIV-1 感染的证据。

Core Evidence Pub Date : 2010-06-15 DOI:10.2147/ce.s6009
Hans-Jürgen Stellbrink
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引用次数: 0

摘要

简介依曲韦林是一种新型非核苷类逆转录酶抑制剂(NNRTI),专门用于抑制对目前批准的三种NNRTI依非韦伦、奈韦拉平和地拉韦啶耐药的病毒的复制。目的:评估依曲韦林在治疗HIV-1感染中的地位:证据回顾:依曲韦林与利托那韦增强型蛋白酶抑制剂联用,对出现多达三种NNRTI耐药突变的病毒株具有很强的抗病毒活性。该药物的耐受性似乎很好,与安慰剂相比,依曲韦林仅有恶心和皮疹的发生率明显较高。值得注意的是,神经心理方面的副作用常常限制了依非韦伦的使用,而依曲韦林在治疗中出现这种副作用的频率并不高:在治疗中的地位:鉴于依曲韦林对大多数 NNRTI 耐药菌株具有很高的活性,而且耐受性非常好,因此对于 NNRTI 耐药和蛋白酶抑制剂暴露的预处理患者来说,依曲韦林具有很高的价值。应努力证明该药物在转换策略(由于毒性)、早期失败或原发性 NNRTI 耐药情况下的活性,以探索该药物在挽救治疗之外的潜力。
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Etravirine (TMC-125): The evidence for its place in the treatment of HIV-1 infection.

Introduction: Etravirine is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI) specifically designed to suppress the replication of viruses resistant to the three currently approved NNRTIs efavirenz, nevirapine, and delavirdine.

Aims: To assess the evidence for the place of etravirine in the treatment of HIV-1 infection.

Evidence review: In combination with a ritonavir-boosted protease inhibitor etravirine has demonstrated high antiviral activity against strains exhibiting up to three NNRTI resistance mutations. The drug appears to be well tolerated, with only nausea and rash occuring significantly more frequently with etravirine compared with placebo. Of note, neuropsychologic side effects that frequently limit the use of efavirenz were not reported more frequently with etravirine.

Place in therapy: Given its high activity against most NNRTI-resistant strains and its very good tolerability, etravirine is of high value for pretreated patients with NNRTI resistance and protease inhibitor exposure. Efforts should be made to demonstrate activity in switching strategies (due to toxicity) and earlier lines of failure or in the setting of primary NNRTI resistance in order to explore the potential of the drug beyond salvage therapy.

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Core Evidence
Core Evidence PHARMACOLOGY & PHARMACY-
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期刊介绍: Core Evidence evaluates the evidence underlying the potential place in therapy of drugs throughout their development lifecycle from preclinical to postlaunch. The focus of each review is to evaluate the case for a new drug or class in outcome terms in specific indications and patient groups The emerging evidence on new drugs is reviewed at key stages of development and evaluated against unmet needs
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