In the summer of this year, the CTN received the highest number of clinical trial submissions ever in one intake. When the CTN was first established, only one anti-HIV drug was available for testing. Seven years later, however, entire new families of drugs have been developed and proven effective in combination. Studies should also factor in issues such as compliance, resistance and cross-resistance, and the use of new ways to measure drug effectiveness, such as viral load assays. He notes that both investigators and pharmaceutical companies are beginning to tackle these complex questions, as evidenced by the impressive array of new CTN trial submissions.
All protocols examine various combination anti-HIV therapies.
Many are multi-centre, international trials. Most feature newer drugs, and utilize combinations from various families of drugs, including nucleoside and non-nucleoside reverse transcriptase inhibitors, as well as protease inhibitors and the first nucleotide reverse transcriptase inhibitor. Because of the increased complexity of combination therapies, many in the HIV community are also calling for the development of management trials. HIV combination treatments can require taking dozens of pills a day and following complicated schedules. Many researchers believe there is a critical need to study how smaller or less frequent doses might improve quality of life and lessen side effects for patients, as well as improve cost effectiveness.