NEWS 12/07/1995
P95-10 Food and Drug Administration
FOR IMMEDIATE RELEASE Arthur Whitmore (301) 443-3285
Dec. 7, 1995
FDA APPROVES FIRST PROTEASE INHIBITOR DRUG FOR TREATMENT OF HIV
The Food and Drug Administration today approved the first
protease inhibitor, a new class of therapy for the treatment of
advanced HIV infection. Saquinavir, the new drug, received
approval for use in combination with older nucleoside analogue
medications only three months after the agency received the
application for its marketing.
"This is some of the most hopeful news in years for people
living with AIDS," said HHS Secretary Donna E. Shalala. "Today's
approval introduces a new class of drugs for treating AIDS. This
drug was approved in just 97 days -- evidence that FDA is carrying
through on the Clinton Administration's priority to review new
drugs, especially the most promising new drugs, on the fastest
possible track consistent with safety."
Commissioner of Food and Drugs David A. Kessler, M.D., pointed
out that five of the six AIDS therapies approved so far were
reviewed in six months or less.
"The review of saquinavir is the fastest approval of any AIDS
drug so far, and demonstrates FDA's flexibility in situations when
saving time can mean saving lives," Kessler said. "When it comes
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to AIDS and other life-threatening diseases, we have learned to
take greater risks in exchange for greater potential health
benefits."
Both protease inhibitors and nucleoside analogues chemically
inhibit replication of the human immunodeficiency virus, although
at different points in the replication process. Nucleoside
analogues include the already-approved anti-HIV drugs AZT, ddC,
ddI, d4T and 3TC.
The agency based its approval of saquinavir on clinical trials
comparing three drug combinations in more than 900 HIV-infected
individuals: saquinavir with AZT, saquinavir with ddC, and
saquinavir with both AZT and ddC. The primary measure of drug
effect was changes in patients' CD4 cell counts, an indication of
immune system strength. (Values greater than 800 per milliliter of
blood are normal in healthy individuals.)
Over 16 weeks of treatment, CD4 cell counts increased an
average of 30 to 40 cells above entry levels in patients on
saquinavir in combination with ddC or AZT or AZT plus ddC. Effects
were attributable to combinations of saquinavir and a nucleoside
analogue to which a patient had not been previously exposed.
Saquinavir doses of less than 600 mg three times a day did not
produce increases in CD4 cell counts. The duration of CD4 cell
increases is not fully determined, although in general it lasted
for at least the 16 weeks of the trials.
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Few adverse events were associated with saquinavir, and for
most patients the drug was well tolerated.
FDA's approval of the saquinavir marketing application was
granted as an accelerated approval, a regulatory mechanism under
which the agency bases early approval for a product on laboratory
markers such as CD4 cell counts, rather than on clinical endpoints
such as delay in death or reduction in opportunistic infections.
FDA may withdraw the approval of products granted accelerated
approval if post-marketing studies fail to verify clinical
benefits. Trials designed to demonstrate clinical benefits of
saquinavir in combination with other nucleoside analogues are
ongoing.
Saquinavir is manufactured by Roche Laboratories under the
trade name Invirase.
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