Treatment Review #15; December 1994
3TC, also known as lamivudine, is an antiretroviral that
works in the same way as AZT, ddI, ddC and d4T. Researchers
studying the drug reported in November of this year that the
combination of 3TC and AZT was effective in improving
laboratory tests of the immune system. Further trials of the
drug to study its clinical benefits will begin next year, the
company said.
In two separate studies, HIV+ participants were given either
AZT, or AZT in combination with 3TC. After 24 weeks, tests
showed that study participants taking the combination therapy
had an increased number of T cells and lower levels of virus
in the blood. The people taking AZT alone either showed less
improvement or got worse, according to their laboratory
tests. These studies did not examine progression to illness,
disease or death, but measured HIV's effects in the blood.
People receiving the combination experienced an average gain
of 85 T4 cells after eight weeks on study and maintained an
increase of 80 T4 cells through week 24. At week 48, an
increase of 49 T4 cells persisted. People receiving only AZT
had their T4 cell counts drop by an average of seven at week
24. When switched to the combination treatment, these people
showed an average increase of 40 T4 cells by week 48.
3TC is in Phase III trials in Europe and the Far East as a
treatment for hepatitis B. Phase III trials are planned for
the US, Canada and Japan in late 1994 and 1995. Side-effects
seen in trials are fatigue and headaches. The company that
makes the drug will file for approval of 3TC in the first
half of 1995. The company expects to report results from two
United States trials comparing AZT, 3TC and the two drugs in
combination in late January. With the release of this
information, the company's stock surged. Many analysts
reacted skeptically, stating, "Popular press overreacts," and
pointing out that three other AIDS drugs for use with AZT
have already been approved.
The data behind the report is based on six months of
treatment and six months of follow-up. It is not know how
well 3TC in combination with AZT would do if taken for a
longer time. Currently, 3TC is in a clinical trial for
children and adolescents in combination with AZT and ddI at
the National Cancer Institute. If you would like more
information about this trial, call The Network. 3TC is also
available through an expanded access program from the drug
company for both children and adults. Children can take the
drug in syrup form. Adults take pills. Doctors can call (800)
248-9757 for more information.