Roche to discontinue Hivid and Fortovase due to lack of demand

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Roche announced this week that it will discontinue production of two of its antiretroviral products, Hivid (zalcitabine, ddC) and Fortovase (soft gel saquinavir) in 2006 or shortly after.

Hivid, the third nucleoside analogue to be licensed, fell out of favour as soon as an alternative to the drug became available in 1995. Hivid’s unpopularity amongst physicians and patients was due to the high frequency of peripheral neuropathy in ddC-treated patients – 17-31% of patients taking the drug in early studies developed the side effect over variable follow-up periods. Hivid is no longer recommended as a preferred component of combination therapy in the United States or United Kingdom, and is not recommended as a component of regimens for resource-limited settings by the World Health Organization.

Fortovase, says Roche, has been superseded by the development of a 500mg Invirase tablet that is better tolerated when boosted with ritonavir.

Glossary

peripheral neuropathy

Damage to the nerves of the hands and/or feet, causing symptoms ranging from numbness to excruciating pain.

nucleoside

A precursor to a building block of DNA or RNA. Nucleosides must be chemically changed into nucleotides before they can be used to make DNA or RNA. 

neuropathy

Damage to the nerves.

combination therapy

A therapy composed of several drugs available either as separate tablets, or as fixed-dose combination (FDC).

boosting agent

Booster drugs are used to ‘boost’ the effects of protease inhibitors and some other antiretrovirals. Adding a small dose of a booster drug to an antiretroviral makes the liver break down the primary drug more slowly, which means that it stays in the body for longer times or at higher levels. Without the boosting agent, the prescribed dose of the primary drug would be ineffective.

Roche says that it is giving plenty of advance warning so that physicians and patients have plenty of time to consider alternative options and move onto them.