Replies to post #1394 on Idenix Pharmaceuticals (IDIX)

[DewDiligence]

>You could make the same argument for using lamivudine as first-line , i.e. , what does it hurt to use the cheapest drug first ? For some patients, it works well for quite a while , for the others, just switch them to something else.<

In most of Asia, the above is exactly what doctors are doing. In the U.S., managed care is not that cheap and most plans now cover the newer HBV agents in the first line.

The VA, by the way, still uses Lamivudine quite a bit. Drug therapy at the VA can be a lot like drug therapy in the Third World.

[DewDiligence]

>…I don't think it matters, except possibly in the limited case of pregnant patients, where treatment with Tyzeka would be preferred , even if the intent was to switch to something else after delivery.<

I disagree strongly with respect to the Tyzeka vs Hepsera comparison. There, the efficacy so strongly favors Tyzeka that other considerations ought not to matter.

For the Tyzeka vs Baraclude comparison, efficacy is sufficiently similar that the other considerations do matter. Tyzeka has a clear edge with pregnant patients and HIV-infected patients (which you forgot to mention in your latest post). For the general patient group (not pregnant, no HIV), I think it boils down to the question I asked in bold-face type in msg #1393.