from Jules: this raises the question that there does not yet appear to be an answer to, how to design studies now for a new HIV ART drug in treatment-experienced patients. This could have an affect on the decision to develop a new HIV drug for treatment-experienced patients. For a new HIV target it might be preferable to study it in naives or someone will have to come up with an ethical study design.
Gathe noted that 56% to 65% of patients taking vicroviroc were sensitive (OSS) to 3 or more drugs, 38-40% were receiving raltegravir and/or darunavir, and etravirine use was minimal in the study.
Gathe discussed how it appears that the number of active drugs uniquely affected the outcomes in this particular study, so for patients with an OSS of 2 or less vicriviroc showed benefit but for patients with an OSS of 3 or more did not appear to provide benefit, and in he 2nd slide below 67% of patients in this study had OSS of 3 or more compared to 37% in the maraviroc phase 3 study and 19% in the raltegravir phase 3 study.