Sunday, August 05, 2007 4:36:34 PM
LOL. I was waiting for you to pounce on that.
I concede. I should have said : " This, IMO, goes a long way towards explaining the recent rapid uptake of entecavir."
Since late '05 or so , entecavir sales have been growing exponentially , doubling every 6 months. They can't keep up that pace indefinitely , of course.
My point remains , however , that entecavir is the most attractive drug in a sequential monotherapy paradigm because of the higher hurdle it provides against resistance.
As you've mentioned several times , the general consensus is that combo tx. will likely favor Ns plus Nt combinations , because of better cross-resistance compatibility. For the same reason , when docs choose a monotherapy for a tx.-naive patient , they have to be thinking about what the second drug will be if rescue therapy is required. Whether the first drug they use is an Ns or an Nt ( adefovir , currently , though many are probably using tenofovir off-label ) , the Ns choice is most likely to be entecavir , IMO.
The evolution of combo therapy is still up for grabs , IMO , as many factors besides resistance patterns can come into play.
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