Elvitegravir

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Elvitegravir
Elvitegravir structure.svg
Elvitegravir3D.PNG
Systematic (IUPAC) name
6-[(3-Chloro-2-fluorophenyl)methyl]-1-[(2S)-1-hydroxy-3-methylbutan-2-yl]-7-methoxy-4-oxoquinoline-3-carboxylic acid
Clinical data
Trade names Stribild (fixed-dose combination)
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
administration
oral
Pharmacokinetic data
Protein binding 98%
Metabolism liver, via CYP3A
Biological half-life 12.9 hours
Excretion liver 93%, renal 7%
Identifiers
CAS Number 697761-98-1 YesY
ATC code J05AX11
PubChem CID 5277135
ChemSpider 4441060 YesY
UNII 4GDQ854U53 YesY
ChEBI CHEBI:72289 N
ChEMBL CHEMBL204656 YesY
NIAID ChemDB 241767
Chemical data
Formula C23H23ClFNO5
Molar mass 447.883 g/mol
 NYesY (what is this?)  (verify)

Elvitegravir (EVG, formerly GS-9137) is an integrase inhibitor used to treat HIV infection. It was developed[1] by the pharmaceutical company Gilead Sciences, which licensed EVG from Japan Tobacco in March 2008.[2][3][4] The drug gained approval by the U.S. Food and Drug Administration on August 27, 2012 for use in adult patients starting HIV treatment for the first time as part of the fixed dose combination known as Stribild.[5] On September 24, 2014 the FDA approved Elvitegravir (tradename Vitekta) as a single pill formulation.[6] On November 5, 2015 the FDA approved the drug for use in patients affected with HIV-1 as a part of a second fixed dose combination pill known as Genvoya.[7]

According to the results of the phase II clinical trial, patients taking once-daily elvitegravir boosted by ritonavir had greater reductions in viral load after 24 weeks compared to individuals randomized to receive a ritonavir-boosted protease inhibitor.[8]

Medical uses[edit]

In the United States, elvitegravir can be obtained either as part of the combination pill Stribild or as the single pill formulation Vitekta.[9]

Vitekta is FDA approved to be used for the treatment of HIV-1 infection in adults who have previous treatment experience with antiretroviral therapy. It must be used in combination with a protease inhibitor that is coadministered with ritonavir as well as additional antiretroviral drug(s).[10]

Adverse effects[edit]

According to the package insert, the most common side effect of taking elvitegravir is diarrhea.[10]

References[edit]

  1. ^ Gilead Press Release Phase III Clinical Trial of Elvitegravir July 22, 2008
  2. ^ Gilead Press Release Gilead and Japan Tobacco Sign Licensing Agreement for Novel HIV Integrase Inhibitor March 22, 2008
  3. ^ Shimura K, Kodama E, Sakagami Y; et al. (2007). "Broad Anti-Retroviral Activity and Resistance Profile of a Novel Human Immunodeficiency Virus Integrase Inhibitor, Elvitegravir (JTK-303/GS-9137)". J Virol 82 (2): 764–74. doi:10.1128/JVI.01534-07. PMC 2224569. PMID 17977962. 
  4. ^ Stellbrink HJ (2007). "Antiviral drugs in the treatment of AIDS: what is in the pipeline ?". Eur. J. Med. Res. 12 (9): 483–95. PMID 17933730. 
  5. ^ Sax, P. E.; Dejesus, E.; Mills, A.; Zolopa, A.; Cohen, C.; Wohl, D.; Gallant, J. E.; Liu, H. C.; Zhong, L.; Yale, K.; White, K.; Kearney, B. P.; Szwarcberg, J.; Quirk, E.; Cheng, A. K.; Gs-Us-236-0102 Study, T. (2012). "Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir versus co-formulated efavirenz, emtricitabine, and tenofovir for initial treatment of HIV-1 infection: A randomised, double-blind, phase 3 trial, analysis of results after 48 weeks". The Lancet 379 (9835): 2439–2448. doi:10.1016/S0140-6736(12)60917-9. PMID 22748591. 
  6. ^ "FDA Approval Bulletin" Accessed November 1, 2014
  7. ^ "Press Announcements - FDA approves new treatment for HIV". www.fda.gov. Retrieved 2016-01-10. 
  8. ^ Thaczuk, Derek and Carter, Michael. ICAAC: Best response to elvitegravir seen when used with T-20 and other active agents Aidsmap.com. 19 Sept. 2007.
  9. ^ "FDA Approved Drug Listing" Accessed November 1, 2014
  10. ^ a b "Vitekta Package Insert" Foster City, CA: Gilead Sciences, Inc.; 2014. Accessed November 1, 2014