Sunday, March 9, 2014

Conference on Retroviruses and Opportunistic Infections Rundown -- MK 5172 and 8742 Data Sets -- HCV/HIV Co-Infection

As we last discussed in detail -- back in March of 2012 -- an important consideration in treating any auto-immune system disorder is the likelihood of a co-infection.

That is to say, patients with hepatitis C, for example, more than occasionally are also HIV positive. And many people with full-blown AIDS also end up contracting Hep C, in no small part as a result of their compromised immune systems, generally. So it was, back in the Spring of 2012, that Vertex's Incivek® (telaprevir) was outperforming Merck's boceprevir (legacy Schering-Plough's actually) in improving patients with both HIV and HCV.

Since then, Gilead has grabbed the current gen lead, and yet-another new class of drugs is on the horizon, and under Phase IIb/III study. Merck's current lead candidates (not so stylishly) labeled MK-5172 and MK-8742, respectively, at the moment are/were showing off some solid mid-stage efficacy -- in such co-infected patients -- in data presented at the Conference on Retroviruses and Opportunistic Infections in Boston, last week.

Here is the well-written Reuters bit on this deelopment -- I was just too busy to get to it, on Friday past (my apologies):

. . . .A combination of oral drugs for hepatitis C developed by Merck & Co appeared to be well tolerated and highly effective in treating the liver disease in patients also infected with HIV, according to data from a midstage clinical trial presented on Wednesday.

The Merck drugs, MK-5172 and MK-8742, which belong to promising new classes of anti-viral medicines, were tested over a 12-week course of treatment both with and without the older hepatitis C drug ribavirin in co-infected patients.

After 12 weeks of treatment, all 29 patients who received the two Merck drugs and ribavirin had undetectable levels of the hepatitis C virus. Among those who got just the experimental Merck drugs, 26 of 29, or 90 percent, appeared to have the hepatitis C virus eliminated from their blood.

If the virus remains undetectable 12 weeks after completion of
treatment, those patients are considered cured. . . .

We will (of course) keep you posted, but as I said at the top, for the moment that Gilead-manufactured, wildly expensive Solvadi® (sofosbuvir) is doing wonders -- in this same co-infected space, through mid-2014. Each new generation however, promises fewer side effects, and robust efficacy across other strains of Hep C. The current generation of biologic Hep C treatments don't do a particularly good job at curing people of African ancestry, for some as yet not well-understood genetic variants. There are so many tiny variations in both the virus, and the host -- it is like looking for one particular needle -- in a haystack -- of needles. Yet each new generation closes this gap, bit by bit -- so we will be cheering vigorously for Merck's twin new candidates, here.

[Disclosure: I have been following this racial disparity pretty closely since 1988, in other fora and media. And we as a planet full of scientists have come quite a way from the days when no one even studied black patients, as a distinct group -- yet all the while researchers were studying Asians, as a group -- since large swaths of that widely-divergent population were living in geographies with first-world, or emerging first-world style medical regimes. And geographies with the much-needed related funding -- for such expensive new treatments. Now you know.]

Be excellent to one another.

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