Amprenavir: new preparation. Another HIV protease inhibitor: no proven advance. 2001


(1) The reference antiretroviral treatment for HIV-infected patients is a three-drug regimen combining drugs from different families, namely two nucleoside reverse transcriptase inhibitors + a protease inhibitor or a non nucleoside reverse transcriptase inhibitor. In our opinion, indinavir is the first-choice protease inhibitor. (2) The clinical file on amprenavir is limited. In particular, it is not known whether the recommended dose regimen (1 200 mg twice a day) is the best one. A 48-week trial involving 232 patients previously untreated with antiretrovirals showed that the combination of amprenavir (1 200 mg) + lamivudine (150 mg) + zidovudine (300 mg), administered twice a day, was more effective than lamivudine + zidovudine on viral load. (3) An unblinded trial involving 504 patients, who had already received a reverse transcriptase inhibitor but no protease inhibitor, compared three-drug regimens consisting of amprenavir (1 200 mg twice a day) and two reverse transcriptase inhibitors, or indinavir (800 mg three times a day) and two reverse transcriptase inhibitors, for 48 weeks. Changes in viral load and the CD4+ lymphocyte count did not favour the amprenavir-containing regimen. (4) Laboratory studies suggest that the risk of cross-resistance between amprenavir and other HIV protease inhibitors is lower than with other compounds of this class. However, it is unclear whether this means that amprenavir would be clinically effective after failure of one or several other protease inhibitors. (5) The main adverse effects of amprenavir are gastrointestinal disorders and paraesthesias. Overall, the safety profile resembles that of the other protease inhibitors. (6) Like other protease inhibitors, amprenavir can potentially interact with many other drugs, owing to its hepatic metabolism. (7) Amprenavir is taken in two daily doses irrespective of meal times, but this advantage over other protease inhibitors is cancelled out by the fact that patients have to swallow 8 large soft capsules at each intake. (8) In our opinion, pending further data, amprenavir should be used only in well-conducted clinical trials.

UI MeSH Term Description Entries
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D013449 Sulfonamides A group of compounds that contain the structure SO2NH2. Sulfonamide,Sulfonamide Mixture,Sulfonamide Mixtures,Mixture, Sulfonamide,Mixtures, Sulfonamide
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017320 HIV Protease Inhibitors Inhibitors of HIV PROTEASE, an enzyme required for production of proteins needed for viral assembly. HIV Protease Inhibitor,Inhibitor, HIV Protease,Inhibitors, HIV Protease,Protease Inhibitor, HIV,Protease Inhibitors, HIV
D023241 Antiretroviral Therapy, Highly Active Drug regimens, for patients with HIV INFECTIONS, that aggressively suppress HIV replication. The regimens usually involve administration of three or more different drugs including a protease inhibitor. Combination Antiretroviral Therapy,HAART,Highly Active Antiretroviral Therapy,Antiretroviral Therapies, Combination,Antiretroviral Therapy, Combination,Combination Antiretroviral Therapies,Therapies, Combination Antiretroviral,Therapy, Combination Antiretroviral

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