Better, Stronger, Faster'and Simpler

The 1970s TV program The Six Million Dollar Man included a memorable phrase during its opening sequence. The scientists on the show pledged to make injured pilot Steve Austin 'better, stronger, faster.' Likewise, scientists involved in antiretroviral research are striving to develop new medications that improve in the same three ways upon existing treatments. But there is an additional goal in mind: 'simpler' treatment regimens. In an effort to simplify anti-HIV treatments pharmaceutical companies are developing pills that contain two or more medications'some that even offer a full day's dosing of a three-drug cocktail in a single pill taken once daily. Two fixed-dose combination pills are already on the market'GlaxoSmithKline's Combivir and Trizivir. But more combination treatments are on the way. Gilead Sciences, Bristol-Myers Squibb, and Merck announced in May the joint development of a three-drug pill combining Gilead nucleoside drugs Emtriva and Viread with the nonnucleoside medication Sustiva, marketed by Merck and BMS. Gilead also submitted a Food and Drug Administration application in March for a two-drug pill containing Emtriva and Viread; a decision is expected by early September. Glaxo is similarly awaiting FDA approval of its new combination pill (containing Epivir and Ziagen) that was submitted to the federal agency in late 2003. A decision on that combination treatment is expected before the end of the year. The company is also working with Boehringer Ingelheim on regimen simplification by hammering out plans to copackage their antiretroviral medications, according to company officials. 'Life has a way of getting in the way of taking medications, especially when you have to take the drugs indefinitely,' says Joseph S. Cervia, MD, director of the Comprehensive HIV Care and Research Center at Long Island Jewish Medical Center. 'Easier-to-administer, once-a-day therapies will definitely help our patients.'