Emtricitabine chemical structure
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Emtriva

Emtricitabine (FTC), with trade name Emtriva® (formerly Coviracil), is a nucleoside reverse transcriptase inhibitor (NRTI) for the treatment of HIV infection in adults. more...

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Emtricitabine is also marketed in a fixed-dose combination with tenofovir (Viread®) under the brand name Truvada®. A fixed-dose triple combination of emtricitabine, tenofovir and efavarenz (Sustiva®, marketed by Bristol-Myers Squibb) is in development.

History

Emtricitabine was discovered by Dr. Dennis Liotta, Dr. Raymond Schinazi and Dr. Woo-Baeg Choi of Emory University and licensed to Triangle Pharmaceuticals by Emory in 1996. Triangle Pharmaceuticals was acquired in 2003 by Gilead Sciences, who completed development and now market the product with the brand name Emtriva®.

It was approved by the FDA July 2, 2003. It is very similar to 3TC and cross-resistance between the two is near-universal.

Mode of action

Emtricitabine is an analogue of cytidine. The drug works by inhibiting reverse transcriptase, the enzyme that copies HIV RNA into new viral DNA. By interfering with this process, which is central to the replication of HIV, emtricitabine can help to lower the amount of HIV, or "viral load", in a patient's body and can indirectly increase the number of immune system cells (called T cells or CD4+ T-cells). Both of these changes are associated with healthier immune systems and decreased likelihood of serious illness.

Indications

Emtricitabine is indicated in combination with other antiretroviral agents for the treatment of HIV infection in adults. This indication is based on the analyses of plasma HIV RNA levels and CD4 cell counts in two Phase III clinical trials of Emtriva of 48 weeks duration.

It is not indicated for the treatment of chronic hepatitis B virus infection and the safety and efficacy of emtricitabine have not been established in patients co-infected with HBV and HIV. Severe acute exacerbations of hepatitis B have been reported in patients after the discontinuation of emtricitabine. The drug is however being evaluated as a potential treatment for chronic hepatitis B. These studies are ongoing.

Side-effects

In clinical practise, toxicity with emtricitabine is unusual. The most common treatment-related adverse events are diarrhea, headache, nausea, and rash. These symptoms are generally mild to moderate in severity, but they caused 1% of clinical trial patients to give up treatment. Skin discoloration, which is typically reported as hyperpigmentation and usually affects either the palms of the hands or the soles of the feet, is reported in under 2% of individuals and is almost exclusive to patients of African origin.

Among the more severe side-effects patients may experience are a hepatotoxicity or a lactic acidosis.

Read more at Wikipedia.org


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One! Two pharmaceutical giants team up to find a simpler, better way to fight HIV
From Advocate, The, 6/21/05 by Bob Adams

Treating HIV disease could become a lot easier for many people who are on a medication regimen. Two of the world's pharmaceutical giants--Bristol-Myers Squibb and Gilead Sciences--have teamed up to create the so-called holy grail of treatment: a single pill containing an entire day's worth of antiretroviral medications.

If approved by the U.S. Food and Drug Administration, the proposed once-a-day pill containing Sustiva, Viread, and Emtriva would be the simplest anti-HIV regimen available.

AIDS treatment advocates have longed for easier-to-take courses of anti-HIV drugs since the early days of combination therapy--when 25 to 30 pills a day could be typical. Even today's simplest regimens require two to four pills daily, which some experts say still makes it burdensome to achieve near-perfect adherence. And recent studies have shown that these medications can lose their effectiveness if taken less than 95% of the time.

"I personally see a lot of patients with new infections and treatment-naive patients, and people want to start with the easiest possible dosing regimen," says Tony Mills, MD, an HIV specialist in Los Angeles who is gay and HIV-positive himself. "The easier the dosing regimen, the more likely you are to be adherent. The better you adhere, the more likely it is that your viral load will remain undetectable in the long term."

BMS spokesman Eric Miller calls the first-of-its-kind collaboration between pharmaceutical rivals an "important milestone" in HIV treatment. "It grew entirely from the companies responding to meet the growing need for increased treatment options," he says.

Because each of the component drugs in the new pill have already been approved individually by the FDA, the new combination treatment could zip through the government approval process, according to the manufacturers, and hit the market as soon as the second half of 2006.

MILESTONES

1984 Researchers discover HIV; it is three years since the first U.S. AIDS cases were reported

1987 AZT is the first medication approved to treatment HIV

1995 invirase is the first protease inhibitor approved for treatment; the era of combination therapy begins

1996 Viramune, the first drug in the third class of antiretrovirals, is approved

1997 Combivir, the first pill to combine two anti-HIV medications, is approved

2000 New medication Trizivir combines three nucleoside analogs into one pill

2002 The first one-pill-a-day formulation of one antiretroviral, Sustiva, is approved

2003 Fuzeon is the first approved medication in the fusion inhibitor class

COPYRIGHT 2005 Liberation Publications, Inc.
COPYRIGHT 2005 Gale Group

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