HPA-23

Last updated
HPA-23
Clinical data
Trade names HPA-23
Routes of
administration 		intravenous
Identifiers
  • Ammonium antimony sodium tungsten oxide
CAS Number
PubChem CID
UNII

HPA-23, sometimes known as antimonium tungstate, is an antiretroviral drug that was used for the treatment of HIV infection. It achieved widespread publicity as an effective treatment for HIV and AIDS beginning in 1984, just one year after HIV was first identified. Later testing failed to demonstrate any efficacy and some patients suffered serious side effects from the drug, including liver failure.

HPA-23 was developed by Rhône-Poulenc at the Pasteur Institute in the 1970s and used in France on an experimental basis to treat HIV and AIDS patients beginning in 1984. [1] [2] The inventors of the drug, as listed in its patent, were Jean-Claude Chermann, Dominique Dormont, Etienne Vilmer, Bruno Spire, Françoise Barré-Sinoussi, Luc Montagnier, and Willy Rozenbaum. [3] While the drug was not presented as a cure for HIV/AIDS, it was suggested it could arrest replication and spread of the virus. [4]

The United States, which had a more stringent drug approval process than France, delayed authorizing use of HPA-23 even for clinical trials, prompting an angry outcry and an exodus of more than 100 American AIDS patients to France to seek treatment, encouraged in part by a French call for American volunteers. [5] [6] Bill Kraus, who received HPA-23 dosages in France as a medical tourist, "pinned his entire hope for survival" on the drug, even to the exclusion of other experimental medications then in development. [7] After actor Rock Hudson received treatment at a Paris hospital with HPA-23, a representative of the National Gay Task Force declared that "something is wrong with the health-care system when a wealthy man and a friend of the President has to go to Europe for treatment". [6] At the same time, however, some within the American scientific community cautioned AIDS sufferers against putting too much hope in HPA-23 and generally supported the Food and Drug Administration's (FDA) conservative approach to certification. [5] [4] William A. Haseltine commented that reports of the drug's success in France were based on "the crummiest kind of anecdotal stories – they don't do the scientifically controlled trials". [4] Physicians at San Francisco General Hospital's AIDS Clinic echoed Haseltine's concerns, noting that French testing of the drug was done without any type of control group and that the drug's high toxicity made it potentially dangerous to patients already suffering serious infections. [4] [8] Public Citizen, which was often critical of FDA decisions, also came out in support of the agency's timeline for certification. [5]

In August 1985, under increasing public pressure to fast track approval of the drug, the United States Food and Drug Administration permitted the use of HPA-23 in extremely limited human testing. [2] [9] In the ensuing clinical trials no improvement in the condition of the test subjects was observed, with some even showing increased levels of HIV replication and three patients suffering liver failure triggered by the drug. [1] [10] By 1986, the National Academy of Sciences had concluded that no therapeutic benefits for persons infected with HIV could be attributed to HPA-23. [11] It was subsequently abandoned as a treatment option. [10]

Related Research Articles

<span class="mw-page-title-main">Zidovudine</span> Antiretroviral medication

Zidovudine (ZDV), also known as azidothymidine (AZT), was the first antiretroviral medication used to prevent and treat HIV/AIDS. It is generally recommended for use in combination with other antiretrovirals. It may be used to prevent mother-to-child spread during birth or after a needlestick injury or other potential exposure. It is sold both by itself and together as lamivudine/zidovudine and abacavir/lamivudine/zidovudine. It can be used by mouth or by slow injection into a vein.

<span class="mw-page-title-main">Nevirapine</span> Chemical compound

Nevirapine (NVP), sold under the brand name Viramune among others, is a medication used to treat and prevent HIV/AIDS, specifically HIV-1. It is generally recommended for use with other antiretroviral medications. It may be used to prevent mother to child spread during birth but is not recommended following other exposures. It is taken by mouth.

<span class="mw-page-title-main">Desonide</span> Chemical compound

Desonide (INN) is a low-potency topical corticosteroid anti-inflammatory that has been available since the 1970s. It is primarily used to treat atopic dermatitis (eczema), seborrheic dermatitis, contact dermatitis and psoriasis in both adults and children. It has a fairly good safety profile and is available as a cream, ointment, lotion, and as a foam under the tradename Verdeso Foam. Other trade names for creams, lotions, and ointments include Tridesilon, DesOwen, Desonate. It is a group VI corticosteroid under US classification, the second least potent group.

<span class="mw-page-title-main">Darunavir</span> Antiretroviral medication

Darunavir (DRV), sold under the brand name Prezista among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat to increase darunavir levels. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth once to twice a day.

<span class="mw-page-title-main">Raltegravir</span> Chemical compound

Raltegravir, sold under the brand name Isentress, is an antiretroviral medication used, together with other medication, to treat HIV/AIDS. It may also be used, as part of post exposure prophylaxis, to prevent HIV infection following potential exposure. It is taken by mouth.

<span class="mw-page-title-main">Maraviroc</span> Antiretroviral drug

Maraviroc, sold under the brand names Selzentry (US) and Celsentri (EU), is an antiretroviral medication used to treat HIV infection. It is taken by mouth. It is in the CCR5 receptor antagonist class.

<span class="mw-page-title-main">Prescription Drug User Fee Act</span> Legislation in the United States

The Prescription Drug User Fee Act (PDUFA) was a law passed by the United States Congress in 1992 which allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the new drug approval process. The Act provided that the FDA was entitled to collect a substantial application fee from drug manufacturers at the time a New Drug Application (NDA) or Biologics License Application (BLA) was submitted, with those funds designated for use only in Center for Drug Evaluation and Research (CDER) or Center for Biologics Evaluation and Research (CBER) drug approval activities. In order to continue collecting such fees, the FDA is required to meet certain performance benchmarks, primarily related to the speed of certain activities within the NDA review process.

Ibalizumab, sold under the brand name Trogarzo, is a non-immunosuppressive humanised monoclonal antibody that binds CD4, the primary receptor for HIV, and inhibits HIV from entering cells. It is a post-attachment inhibitor, blocking HIV from binding to the CCR5 and CXCR4 co-receptors after HIV binds to the CD4 receptor on the surface of a CD4 cell. Post-attachment inhibitors are a subclass of HIV drugs called entry inhibitors.

<span class="mw-page-title-main">Elvitegravir</span> Chemical compound

Elvitegravir (EVG) is an integrase inhibitor used to treat HIV infection. It was developed by the pharmaceutical company Gilead Sciences, which licensed EVG from Japan Tobacco in March 2008. 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. On September 24, 2014, the FDA approved Elvitegravir as a single pill formulation under the trade name Vitekta. 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.

<span class="mw-page-title-main">Rilpivirine</span> HIV treatment

Rilpivirine, sold under the brand names Edurant and Rekambys, is a medication, developed by Tibotec, used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency, longer half-life and reduced side-effect profile compared with older NNRTIs such as efavirenz.

Leronlimab is a humanized monoclonal antibody targeted against the CCR5 receptor found on T lymphocytes of the human immune system. It is being investigated as a potential therapy in the treatment of COVID-19, triple negative breast cancer, and HIV infection. The United States Food and Drug Administration has designated PRO 140 for fast-track approval. In February 2008, the drug entered Phase 2 clinical trials and a phase 3 trial was begun in 2015. In February 2018, Cytodyn Inc reported that the primary endpoint had been achieved in the PRO 140 pivotal combination therapy trial in HIV infection. In 2020 CytoDyn submitted a fast-track biologics license application for treatment of CCR5-tropic HIV-1 Infection.

Martin "Marty" Delaney was an advocate for HIV/AIDS treatments. In 1985, he founded Project Inform, an education and public policy advocacy group concerned with HIV and AIDS, and continued to lead the organization until 2008. Delaney's efforts to streamline the US Food and Drug Administration's drug approval process have been credited with saving thousands of people from early AIDS deaths.

<span class="mw-page-title-main">Lopinavir/ritonavir</span> Combination medication for HIV/AIDS

Lopinavir/ritonavir (LPV/r), sold under the brand name Kaletra among others, is a fixed-dose combination antiretroviral medication for the treatment and prevention of HIV/AIDS. It combines lopinavir with a low dose of ritonavir. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth as a tablet, capsule, or solution.

<span class="mw-page-title-main">Dolutegravir</span> Chemical compound

Dolutegravir (DTG), sold under the brand name Tivicay, is an antiretroviral medication used, together with other medication, to treat HIV/AIDS. It may also be used, as part of post exposure prophylaxis, to prevent HIV infection following potential exposure. It is taken by mouth.

<span class="mw-page-title-main">HIV/AIDS research</span> Field of immunology research

HIV/AIDS research includes all medical research that attempts to prevent, treat, or cure HIV/AIDS, as well as fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.

<span class="mw-page-title-main">Fostemsavir</span> Chemical compound

Fostemsavir, sold under the brand name Rukobia, is an antiretroviral medication for adults living with HIV/AIDS who have tried multiple HIV medications and whose HIV infection cannot be successfully treated with other therapies because of resistance, intolerance or safety considerations.

Sofosbuvir/velpatasvir, sold under the brand name Epclusa among others, is a fixed-dose combination medication for the treatment of hepatitis C in adults. It combines sofosbuvir and velpatasvir. It is more than 90% effective for hepatitis C genotypes one through six. It also works for hepatitis C in those who also have cirrhosis or HIV/AIDS. It is taken by mouth.

The Immune Response Corporation (IRC) was a pharmaceutical company that worked in the development of immunotherapeutic products. The firm was founded by Jonas Salk and Kevin Kimberlin when Kimberlin, "asked Salk to become lead scientific advisor for a new biotech company specializing in 'anti-idiotypes,' a novel vaccine technology." Salk called the proposal "liberating."

<span class="mw-page-title-main">Cabotegravir/rilpivirine</span> Co-packaged antiretroviral medication

Cabotegravir/rilpivirine, sold under the brand name Cabenuva, is a co-packaged antiretroviral medication for the treatment of HIV/AIDS. It contains cabotegravir and rilpivirine in a package with two separate injection vials.

<span class="mw-page-title-main">Lenacapavir</span> Antiretroviral medication

Lenacapavir, sold under the brand name Sunlenca, is an antiretroviral medication used to treat HIV/AIDS. It is taken by mouth or by subcutaneous injection.

References

  1. 1 2 Nichols E (1989). Mobilizing Against AIDS . Harvard University Press. p.  221. ISBN   978-0674577626.
  2. 1 2 "AIDS Drug Approved For Experimental Use". New York Times . 18 September 1985. Retrieved 12 July 2017.
  3. ↑ "Novel treatment US 4759929 A". Google Patents. Retrieved July 12, 2017.
  4. 1 2 3 4 Altman L (30 July 1985). "The Doctor's World: Search for an AIDS Drug is a Case History in Frustration". New York Times . Retrieved 12 July 2017.
  5. 1 2 3 Van J (August 4, 1985). "Hudson Aids Case Turns Spotlight On Drug Approval Process". Chicago Tribune . Retrieved July 12, 2017.
  6. 1 2 Jarvis J (12 August 1985). "Desperate American AIDS Victims Journey to Paris, Hoping That a New Drug Can Stave Off Death". People Magazine . Retrieved 12 July 2017.
  7. ↑ Annas G (2005). Standard of Care: The Law of American Bioethics. Oxford University Press. p. 138. ISBN   978-0195120066.
  8. ↑ "Scientists caution about French AIDS drug". UPI . 28 July 1985. Retrieved 12 July 2017.
  9. ↑ Mayer K (Winter 1988). "The Clinical Implications for Spectrum of HIV Public Policy Infections". New England Journal of Public Policy: 46.
  10. 1 2 Holmberg S (2008). Scientific Errors and Controversies in the U.S. HIV/AIDS Epidemic: How They Slowed Advances and Were Resolved. Greenwood Publishing Group. pp. 148–150. ISBN   978-0313347177.
  11. ↑ Confronting AIDS: Directions for Public Health, Health Care, and Research . National Academies. 1986. p.  215. ISBN   9780309036993.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.