Replies to post #1550 on Idenix Pharmaceuticals (IDIX)

[gofishmarko]

>>> Huh? Entecavir’s sales uptake was far from rapid. <<<


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.