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FDA approves first monthly injectable to treat HIV infection

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Re: FDA approves first monthly injectable to treat HIV infection

#21

Post by Grazester »

dougmwne wrote: post #20
Grazester wrote: post #18

Earlier quoted context omitted.

The article states, "...abotegravir – a component of Cabenuva – was 89% more effective in preventing infection among women than Truvada" That 89% when was compared to Truvada. Do healthcare workers actively take Prep or is it administered within the 72 hour period after exposure? Prep from what I understand can be hard on the body's organs and you will need to do a kidney function test every few months when on it

Truvada is commonly taken proactively by sexually active people in high risk categories. It is true that it has side effects, so the risk of those needs to be balanced against the risk of HIV exposure.

Yes I do know it is take by high risk sexually active people. But I was wondering about health workers themselves and in what health field exactly.

Re: FDA approves first monthly injectable to treat HIV infection

#23

Post by Merman_Mike »

grawprog wrote: post #9
Merman_Mike wrote: post #5

Earlier quoted context omitted.

Instead of downvotes, I'm curious what evidence there is on either side of this claim.

https://www.ncbi.nlm.nih.gov/books/NBK217902/ https://fee.org/articles/curing-diseases-is-sustainable-gove... https://www.bmj.com/content/363/bmj.k4351 https://theconversation.com/amp/how-pharmaceutical-companies... https://yaledailynews.com/blog/2017/02/09/lewis-the-need-for... https://www.medpagetoday.com/blogs/revolutionandrevelation/7... https://pnhp.org/news/eliminate-the-profit-motive-in-health-...

Many of these seem to support GP's comment.

Re: FDA approves first monthly injectable to treat HIV infection

#24

Post by gizmo686 »

dougmwne wrote: post #6

I have always heard that Truvada (prep) was extremely effective at preventing HIV infection. These new injectables are reported by the article to be 89% and 66% more effective at preventing transmission. What is this based on? Was I misinformed about Truvada's effectiveness? Is this a decrease in an already very low chance of transmission? Or is this in comparison to people forgetting to take their daily pills vs a s…

It is a decrease in already low transmission. For ethical reasons, the placebo group is not no treatment, but rather current standard of care.

I had to do some digging to find any source on the effectiveness on preventing transmission (the recent FDA approval is for post infection treatment).

The study I found is [0]. In a double blinded study of 4,600 participants, half were given the cabotegravir injection, and half were given the daily oral treatment. The study notes a "high level of adherence to oral therapy"; however, the actual numbers on adherence are:

> Adherence to oral FTC/TDF was high, based on a random subset sampling that detected tenofovir (> 0.31 ng/ml) in 87% of all samples tested.

I'm not qualified to say if this actually indicates 87% adherence, or if a fully compliant patient may get a negative result on that test.

The result of this study was that 50 particpants got HIV, of which 12 were on the injectable and 38 were on the oral.

By my calculation, this gives a relative effectiveness of (38-13)/38 = 68.4%, although the paper reports 69%.

[0] https://viivhealthcare.com/en-us/us-news/us-articles/2020/gl...

Re: FDA approves first monthly injectable to treat HIV infection

#25

Post by incrudible »

dougmwne wrote: post #12
Merman_Mike wrote: post #5

Earlier quoted context omitted.

Instead of downvotes, I'm curious what evidence there is on either side of this claim.

I am sure there is some evidence on both sides, but at the end of the day, people get into medicine and medical research to heal people, not keep them sick. The USA does not have the only medical system in the world and many countries run their systems with the goal of controlling costs, not increasing them. I don't think this kind of pessimistic conspiracy thinking adds to the conversation.

If there's more money to be made from keeping people sick than outright curing them, that logically is a disincentive from curing them.

It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes.

Of course, there's a moral incentive to not keep people sick, but history shows that we can not rely on people acting morally. The pessimism is justified.

If we expect companies to provide cures over treatments, we at least must allow them to profit as much or more from a cure as they would from a treatment.

Re: FDA approves first monthly injectable to treat HIV infection

#26

Post by call_me_dana »

eli wrote: post #14
Merman_Mike wrote: post #5

Earlier quoted context omitted.

Instead of downvotes, I'm curious what evidence there is on either side of this claim.

I'm not sure every claim is worthy of debate. Setting aside all the private investment and philanthropy dollars going towards a cure, governments spend billions annually on HIV research.

Yes, they spend billions on developing the exact types of treatments that this article is about. Their business model depends on maximizing revenue so any treatment cannot cure the patient and it cannot kill the patient. Sad, but true.

Re: FDA approves first monthly injectable to treat HIV infection

#27

Post by blithedale »

Grazester wrote: post #18
dougmwne wrote: post #6

I have always heard that Truvada (prep) was extremely effective at preventing HIV infection. These new injectables are reported by the article to be 89% and 66% more effective at preventing transmission. What is this based on? Was I misinformed about Truvada's effectiveness? Is this a decrease in an already very low chance of transmission? Or is this in comparison to people forgetting to take their daily pills vs a s…

The article states, "...abotegravir – a component of Cabenuva – was 89% more effective in preventing infection among women than Truvada" That 89% when was compared to Truvada. Do healthcare workers actively take Prep or is it administered within the 72 hour period after exposure? Prep from what I understand can be hard on the body's organs and you will need to do a kidney function test every few months when on it

Truvada is PREP. PRE exposure prophylaxis.

PEP =/= PREP. PEP is after the fact treatment, there's more than just Truvada in that protocol.

PEP is typically much harder on the body than PREP.

Most every gay man I know takes PREP with few or no side effects.

Re: FDA approves first monthly injectable to treat HIV infection

#28

Post by ed25519FUUU »

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S.

This number seems insane to me in the USA. Why is a well known deadly disease, with well understood transmission vectors, still spreading so prominently here?

Re: FDA approves first monthly injectable to treat HIV infection

#29

Post by bpodgursky »

ed25519FUUU wrote: post #28

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S. This number seems insane to me in the USA . Why is a well known deadly disease, with well understood transmission vectors, still spreading so prominently here?

Because people really, really like having risky and unsafe sex?

Re: FDA approves first monthly injectable to treat HIV infection

#30

Post by jjcon »

incrudible wrote: post #25
dougmwne wrote: post #12

Earlier quoted context omitted.

I am sure there is some evidence on both sides, but at the end of the day, people get into medicine and medical research to heal people, not keep them sick. The USA does not have the only medical system in the world and many countries run their systems with the goal of controlling costs, not increasing them. I don't think this kind of pessimistic conspiracy thinking adds to the conversation.

If there's more money to be made from keeping people sick than outright curing them, that logically is a disincentive from curing them. It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes. Of course, there's a moral incentive to not keep people sick, but history shows that we can not rely on people acting morally. The pessimism is justified. If we expe…

> we at least must allow them to profit as much or more from a cure as they would from a treatment

I think that’s where you go wrong. There are huge profit incentives for a cure. If a biotech company comes up with a cure they will instantly have the business of every afflicted person on the planet. The market for that and price they can charge will be way larger than a slightly different treatment.

Beyond that, there are labs all over the world funded by public dollars to research avenues to a cure, it’s just way more complicated than effective treatment.

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