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Being Alive
MEDICAL UPDATE: ddI vs. ddC Revisited
Mark Katz, MD and reported by Jim Stoecker
April 5, 1993
Being Alive 1993 Apr 5: 12

Many of you may have read the stories in the Los Angeles Times and elsewhere about the federally sponsored study that compared ddI to ddC. The newspapers touted a preliminary result that showed there were fewer deaths among the study subjects on ddC than there were among those on ddI. The implication was that ddC was the superior antiviral.

Now the National Institute of Allergies and Infectious Diseases has officially released the study results. This study included 467 AZT resistant subjects with advanced HIV disease (average T cell count of 37). During the course of the study, 100 people on ddI died and 87 of those on ddC died. This result is not statistically significant. When we consider other markers of disease progression, such as the appearance of new OIs, the results were virtually the same for both drugs.

Despite the flurry in the media, then, ddC has not been proved superior in efficacy to ddI. What this study does suggest, however, is that ddC may be able to stand on its own as an antiviral. As you know, ddC is currently approved for use only in combination with AZT. The FDA is now reviewing its data on ddC in order to determine whether it makes sense to approve the drug's use as a stand-alone antiviral.