Pharmaceutical giant Bristol-Myers Squibb is simply not satisfied with resting on its laurels after its successful partnership earlier this year with Gilead Sciences--a partnership that resulted in the first one-pill-a-day anti-HIV therapy, Atripla. Looking forward, the drugmaker is teaming up with yet another company with the goal of producing a new drug that could further advance the fight against drug-resistant viruses.
In September, BMS announced a licensing agreement with Swedish biotechnology firm Medivir. BMS will add its financial muscle and global reach to help develop a potential new medication that Medivir has so far created in-house. Called MIV-170, the drug is a nonnucleoside reverse transcriptase inhibitor. Currently, the National Institutes of Health recommends nonnuke combinations as the best choice for patients going on anti-HIV therapy for the first time. Triple-med cocktails based on Sustiva (which is one of the drugs included in Atripla) or Viramune are the gold standard.
Nonnukes have been shown effective at fighting HIV and also to carry less potential for troublesome side effects like diabetes, high cholesterol, or lipodystrophy. However, nonnukes do put patients at high risk of developing drug resistance. And once the virus becomes resistant to one nonnuke, it's possible that the whole class of drugs will no longer be effective.
But drug companies are trying to move the fight against HIV to the next level by creating easy-to-tolerate drugs that don't put HIVers at so much risk for drug resistance. According to BMS spokesman Eric Miller, 'MIV-170 has demonstrated excellent potency' in laboratory testing, allowing the company to predict that the human body will likely process the drug effectively. He says research has also found that the drug may fight resistance better than the nonnukes available today.
Miller adds that the drug belongs to a new subclass of nonnukes that attacks HIV in slightly different ways than the ones currently available because of its different chemical structure. According to Anthony Urbina, an HIV specialist at St. Vincent's Comprehensive HIV Center in Manhattan, a patient who is already resistant to nonnukes, though, might still be sensitive to a nonnuke with a different chemical structure. But Urbina adds that nonnukes that both operate in new ways and that are also better at fighting resistance would 'greatly add to clinicians' ability to construct effective cocktails' in their patients who have already run through many treatment options.
Martin Delaney, founding director of Project Inform, is cautiously optimistic about the future of the nonnuke market. As for the potential success of MIV-170, he points out that BMS and Medivir are competing against the various other companies that are currently developing this class of drugs. 'I think it's a question of who's going to come to the market first,' Delaney says, 'and what kind of resistance profiles their drugs have.'
Delaney also has a slightly different take than Miller on BMS and Medivir's research data showing that MIV-170 might have a better ability to fight drug resistance than today's nonnukes. 'We just don't have that much information about the resistance profiles of these drugs,' he says, 'except that it's different from what we have.'