The treatment landscape for HIV has evolved significantly over the years, with several drugs emerging as best sellers due to their efficacy and reliability. Here, we take a closer look at the top-selling HIV medications, detailing their active ingredients, mechanisms of action, FDA approval dates, and other noteworthy information.
1. Biktarvy by Gilead - $11.9 Billion
Active Ingredients: Bictegravir, Emtricitabine, and Tenofovir Alafenamide
Mechanism of Action: Biktarvy is a combination of three antiretroviral medications. Bictegravir is an integrase strand transfer inhibitor (INSTI), while Emtricitabine and Tenofovir Alafenamide are nucleoside reverse transcriptase inhibitors (NRTIs). Together, these drugs work by inhibiting enzymes necessary for the replication of HIV, thereby reducing the viral load in the body.
FDA Approval Date: February 7, 2018
Additional Information: Biktarvy is highly valued for its once-daily dosing regimen and minimal side effects, making it a popular choice among patients and healthcare providers.
2. Dovato by GSK - $2.3 Billion
Active Ingredients: Dolutegravir and Lamivudine
Mechanism of Action: Dovato combines Dolutegravir, an integrase strand transfer inhibitor (INSTI), with Lamivudine, a nucleoside reverse transcriptase inhibitor (NRTI). This dual therapy is effective in preventing the virus from replicating within the body.
FDA Approval Date: April 8, 2019
Additional Information: Dovato is significant for being a two-drug regimen, offering a simplified treatment option for patients, which can reduce potential side effects and drug interactions compared to three-drug regimens.
3. Genvoya by Gilead - $2.0 Billion
Active Ingredients: Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide
Mechanism of Action: Genvoya is a combination of four medications. Elvitegravir is an integrase strand transfer inhibitor (INSTI), Cobicistat is a pharmacokinetic enhancer, and Emtricitabine and Tenofovir Alafenamide are nucleoside reverse transcriptase inhibitors (NRTIs). This combination helps to control HIV by inhibiting the virus's replication process.
FDA Approval Date: November 5, 2015
Additional Information: Genvoya is appreciated for its efficacy and improved renal and bone safety profile compared to previous tenofovir-based treatments.
4. Descovy by Gilead - $2.0 Billion
Active Ingredients: Emtricitabine and Tenofovir Alafenamide
Mechanism of Action: Descovy combines two nucleoside reverse transcriptase inhibitors (NRTIs), which work together to prevent HIV from multiplying in the body.
FDA Approval Date: April 4, 2016
Additional Information: Descovy is often used in combination with other antiretroviral agents and is noted for its safety profile, especially regarding kidney and bone health.
5. Triumeq by GSK - $2.0 Billion
Active Ingredients: Abacavir, Dolutegravir, and Lamivudine
Mechanism of Action: Triumeq is a combination of three drugs: Abacavir and Lamivudine, which are nucleoside reverse transcriptase inhibitors (NRTIs), and Dolutegravir, an integrase strand transfer inhibitor (INSTI). This regimen effectively suppresses HIV by preventing the virus from integrating into the host DNA and replicating.
FDA Approval Date: August 22, 2014
Additional Information: Triumeq is particularly effective for patients who test negative for the HLA-B*5701 allele, which is associated with hypersensitivity to Abacavir.
6. Prezista by J&J - $1.9 Billion
Active Ingredient: Darunavir
Mechanism of Action: Prezista is a protease inhibitor that works by blocking the protease enzyme, which is necessary for the HIV virus to mature and multiply.
FDA Approval Date: June 23, 2006
Additional Information: Prezista is often used in combination with other antiretroviral medications and is known for its potency and effectiveness in patients with drug-resistant HIV strains.
7. Tivicay by GSK - $1.8 Billion
Active Ingredient: Dolutegravir
Mechanism of Action: Tivicay is an integrase strand transfer inhibitor (INSTI) that prevents HIV from integrating into the DNA of human cells, thus inhibiting viral replication.
FDA Approval Date: August 12, 2013
Additional Information: Tivicay is often used in combination with other antiretrovirals and is praised for its high barrier to resistance and efficacy in various patient populations.
8. Odefsey by Gilead - $1.4 Billion
Active Ingredients: Emtricitabine, Rilpivirine, and Tenofovir Alafenamide
Mechanism of Action: Odefsey combines two nucleoside reverse transcriptase inhibitors (NRTIs) with a non-nucleoside reverse transcriptase inhibitor (NNRTI), Rilpivirine. This combination works to block different stages of the HIV replication cycle.
FDA Approval Date: March 1, 2016
Additional Information: Odefsey is notable for its once-daily dosing and suitability for patients who are virologically suppressed on a stable antiretroviral regimen.
9. Isentress by Merck - $0.48 Billion
Active Ingredient: Raltegravir
Mechanism of Action: Isentress is an integrase strand transfer inhibitor (INSTI) that blocks the HIV integrase enzyme, preventing the integration of viral DNA into the host genome.
FDA Approval Date: October 12, 2007
Additional Information: Isentress was the first integrase inhibitor approved for HIV treatment and remains a critical component in various treatment regimens.
10. Complera by Gilead - $129 Million
Active Ingredients: Emtricitabine, Rilpivirine, and Tenofovir Disoproxil Fumarate
Mechanism of Action: Complera is a combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and a non-nucleoside reverse transcriptase inhibitor (NNRTI), which work together to inhibit the replication of HIV.
FDA Approval Date: August 10, 2011
Additional Information: Complera is typically used in patients who are virologically suppressed and looking for a single-tablet regimen.
Conclusion
The HIV treatment landscape is continuously evolving, with these top-selling drugs providing effective and reliable options for managing the disease. Each medication offers unique benefits, from simplified dosing regimens to improved safety profiles, addressing the diverse needs of patients living with HIV.
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