Fosamprenavir: advancing HIV protease inhibitor treatment options.
Fosamprenavir, the prodrug formulation of amprenavir, is a protease inhibitor recently approved in the US for the treatment of HIV infection. This agent combines the pharmacological profile of amprenavir with a low pill burden and flexible dosing schedule. Three large international trials have been completed. In treatment-naive patients, fosamprenavir, both ritonavir-boosted and -unboosted, met primary end points of non-inferiority against nelfinavir. Among naive patients, no protease inhibitor mutations emerged in those failing the boosted fosamprenavir regimen. Boosted fosamprenavir was compared to lopinavir/ritonavir in treatment-experienced patients. Non-inferiority was not achieved but similar numbers of patients achieved viral suppression when fosamprenavir was dosed twice-daily. Fosamprenavir demonstrates a favourable lipid profile in naive patients, and a low incidence of adverse effects. Fosamprenavir, as with lopinavir/ritonavir, distinguishes itself among other protease inhibitors with its potent activity in those with advanced HIV. Future trials comparing fosamprenavir with current standard regimens will further assist in defining its role in clinical practice.
Becker
Stephen
S
Pacific Horizon Medical Group, 2351 Clay Street, Suite 512, San Francisco, CA 94115, USA. SLBecker@mindspring.com
Thornton
Lorna
L
D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D002219:Carbamates; D017326:Clinical Trials, Phase III as Topic; D051544:Cytochrome P-450 CYP3A; D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D004790:Enzyme Induction; D005663:Furans; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D010755:Organophosphates / Q000494:pharmacology / Q000627:therapeutic use*; D011355:Prodrugs; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D002219:Carbamates; D065607:Cytochrome P-450 Enzyme Inhibitors; D005663:Furans; D017320:HIV Protease Inhibitors; D010755:Organophosphates; D011355:Prodrugs; D013449:Sulfonamides; D003577:Cytochrome P-450 Enzyme System; C104464:CYP3A protein, human; D051544:Cytochrome P-450 CYP3A; C426859:fosamprenavir