September 11, 1997 in Nation/World

New Drugs Major Step In Containing Aids Virus

Stephen Smith Knight-Ridder

Providing powerful new evidence of the potency of AIDS-fighting drug cocktails, scientists will report today that the medications succeed in squashing the AIDS virus in patients beyond detection for a year or longer.

Still, nobody - not University of Miami researchers, not their scientific collaborators across the country, not even the patients who have benefited the most - is ready to proclaim the combination drug therapy a panacea.

It is, undeniably, a scientific success story.

But researchers caution that the drugs were significantly less successful in people with the most advanced cases of AIDS, suggesting that doctors and patients must act swiftly, powerfully and early if the disease is to be vanquished.

Veterans in the war on AIDS, researchers like Miami’s Margaret Fischl, are particularly wary of making sweeping pronouncements. They remember what happened a decade ago, when the drug AZT was hailed as a potential panacea, a promise unfulfilled.

“I don’t want to see the backlash we saw with AZT when it failed - I do not want to see that again,” said Fischl, both vaunted and vilified for her role in studying AZT. Two studies appearing in today’s New England Journal of Medicine offer the strongest proof yet of the drugs’ ability to eradicate the virus from patients’ blood while simultaneously stimulating production of vital disease-fighting cells.

The study that UM participated in involved 1,156 patients, believed to be the biggest trial ever of the combination drug therapies. Patients were divided into two groups: One segment of patients was given a two-drug combination constituted of two earlier generation AIDS drugs, AZT and 3TC. The second class got those older drugs plus indinavir (marketed as Crixivan), a member of a powerful family of AIDS medications called protease inhibitors.

The researchers’ findings: Patients who got the three-drug regimen were half as likely to die or progress onto full-blown AIDS. And they were more likely to have increases in disease-fighting cells and decreases in AIDS virus.

The results augur strongly in favor of a fundamental shift in the way AIDS is treated, researchers said. And evidence that people who got the drugs earlier in the disease fared better tells doctors that it’s vital to blast the virus so that it does not have time to mutate and become resistant to drugs.

“In the long run, our greatest nemesis will be that drug resistance,” Fischl said.

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