The standard treatment for HIV infection involves taking a combination of three HIV drugs. The main reason for using multiple substances is to prevent resistance from developing rapidly when only one or two drugs are used.
However, in recent years, studies have shown that the risk of resistance developing is significantly lower once viral replication in the body has been completely suppressed. Studies have now been conducted on this maintenance therapy phase, which aims to reduce the number of drugs used.
Some positive results have been reported with monotherapy. There have been positive results with both protease and integrase inhibitors. However, both groups of drugs demonstrate monotherapy failure in 10-20% of patients. We suspect that poor penetration into the genital tract and brain is partly responsible for this.
In contrast, recent studies on the dual combination of protease or integrase inhibitors with lamivudine have demonstrated excellent efficacy. Lamivudine is known to work very well in the brain and genital tract. Since HIV medication must be taken for life, simplifying therapy is very important. This reduces the potential for long-term side effects and costs.
The Clinic for Infectious Diseases and Hospital Hygiene at the Cantonal Hospital of St. Gallen in Switzerland has many years of experience with nevirapine, an HIV medication introduced over 20 years ago. One third of patients are treated with this substance. Of the additional preparations used in combination with nevirapine, one contains lamivudine (or its analogue, emtricitabine), plus either abacavir or tenofovir. The latter two have potentially significant long-term side effects, including an increased risk of cardiovascular disease and kidney/bone toxicity.
A dual combination of nevirapine and lamivudine is highly likely to be effective. Furthermore, it is the most favourable of all the alternative combinations. Based on current knowledge, this combination appears to have no long-term side effects.
After conducting a controlled pilot study with 20 patients at the KSSG (Kahlert, 2020, https://doi-org.libproxy1.nus.edu.sg/10.1371/journal.pone.0237770), data was obtained showing that the combination of nevirapine and lamivudine is effective in maintaining viral suppression. None of the patients experienced 'viral blips' (temporarily detectable virus concentrations of 50-200 HIV RNA copies/ml of blood), which are known to occur in monotherapy studies. After an observation period of 72-96 weeks, all patients showed sustained stable viral suppression (<50 HIV RNA copies/ml of blood).
The aim of this study is to evaluate the dual combination of nevirapine and lamivudine in a multicentre setting. The intervention involves switching well-selected patients with no history of treatment failure who have been on long-term, stable, well-suppressed HIV therapy with nevirapine from triple combination therapy to nevirapine plus lamivudine. The study is a non-inferiority trial compared to a virtual control group receiving stable standard combination therapy with 0% treatment failure.
The primary outcome parameter used to assess the non-inferiority of the dual combination is the proportion of patients experiencing treatment failure, as determined by a viral load of ≥200 HIV RNA copies/ml at weeks 6, 12, 24, 36 and 48 of treatment.

开始日期2019-04-12

申办/合作机构

Kantonsspital St. Gallen

CTRI/2018/01/011185

/ RecruitingN/A

An open label, randomized, single centre two-treatment, two-sequence, two-period, crossover, multiple dose comparative oral bioavailability study of Nevirapine Prolonged Release Tablets 400 mg (Test) of Aurobindo Pharma Ltd., India and Viramune (Nevirapine) 400 mg Prolonged-Release Tablets (Reference) of Boehringer Ingelheim Pharma GmbH & Co.KG, Germany in 36 HIV-1 Infected Patients under fasting conditions.

开始日期2018-01-20

申办/合作机构

APL Research Centre Ltd.

100 项与奈韦拉平相关的临床结果

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100 项与奈韦拉平相关的转化医学

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100 项与奈韦拉平相关的专利（医药）

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5,258

项与奈韦拉平相关的文献（医药）

2025-12-31·HIV Research & Clinical Practice

Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023

Review

作者: Mboowa, Gerald ; Wanyengera, Misaki ; Mukasa Kafeero, Hussein ; Muwanda, Fahad ; Miya, Yunus ; Nakatumba Nabende, Joyce ; Kato, Darius ; Kabahiita, Jupiter Marina ; Joloba, Moses ; Jjingo, Daudi ; Kateete, David Patrick ; Ouma, Simple ; Ssewanyana, Isaac ; Namaganda, Maria Magdalene ; Kanyerezi, Stephen ; Kakembo, Frederick Elishama ; Batte, Charles ; Kivunike, Florence

BACKGROUND:

Virological failure (VF) significantly threatens the efficacy of antiretroviral therapy (ART) programs in East Africa. This systematic review and meta-analysis assess the prevalence and predictors of VF among individuals living with HIV.

METHODS:

We searched PubMed, Web of Science, African Journals Online, and EMBASE for relevant studies. Heterogeneity was assessed using the I² statistic, and random-effects models addressed between-study variability. Publication bias was examined through funnel plots, Egger's regression, and Begg's tests. Subgroup analyses and meta-regression explored heterogeneity sources and potential VF predictors. Analyses were conducted using MedCalc version 20.010, adhering to PRISMA 2020 guidelines.

RESULTS:

Twenty-five records were included, with a sample size of 29,829 people living with HIV on ART. The pooled prevalence of VF in East Africa was 19.4% (95% CI: 15.2%-24.0%), with substantial heterogeneity across studies. Sociodemographic predictors of VF included male sex (30.9%, p < .001), unmarried status (28.2%, p < .001), lower educational attainment (33.0%, p < .001), non-formal employment (47.2%, p < .001), and urban residence (51.2%, p < .001). Clinical factors associated with higher VF rates were ambulatory status (44.7%, p < .001), low CD4 count (35.1%, p < .001), low haemoglobin (52.2%, p < .001), advanced HIV stage III/IV (44.2%, p < .001), HIV/TB co-infection (24.3%, p < .001), and other opportunistic infections (20.5%, p = .008). Treatment-related factors associated with VF were first-line nevirapine-based regimen (27.7%, p = .009) and poor ART adherence (41.76%, p < .001).

CONCLUSION:

Sociodemographic factors, advanced HIV disease, co-morbidities, poor adherence, and specific first-line ART regimens are key predictors of virological failure. Targeted, multidisciplinary interventions focusing on routine viral load monitoring, adherence support, and addressing socioeconomic barriers are essential to improve ART outcomes in East Africa.

2025-12-01·JOURNAL OF COLLOID AND INTERFACE SCIENCE

Engineering vacancy-rich van der Waals heterostructures in high-conductivity carbon networks for ultrastable sodium storage

Article

作者: Wang, Hongxia ; Li, Peihua ; Zhao, Yibo ; Liu, Yiming ; Zhang, Wanggang ; Wang, Jian ; Tian, Rufeng

Rational design and application of high performance anodes are crucial for advancing sodium-ion batteries (SIBs). In this work, the 3D Mo-ZIF-L is subjected to a directional cross-linking process, followed by g-C₃N₄ incorporation to modify the self-assembled precursor, ultimately yielding a high-conductivity carbon material. Subsequently, bimetallic selenide (ZnSe/MoSe₂) is successfully loaded onto the carbon surface via chemical vapor deposition. This strategy simultaneously created van der Waals (vdW) heterostructures and abundant vacancies while alleviating volume expansion during cycling, endowing the ZnSe/MoSe₂-C@g-C₃N₄ (ZMSCN) with stable sodium storage ability (358.4 mAh g^-1 after 3000 cycles at 5 A g^-1). The remarkable performance originates from enhanced charge transfer at p-type/n-type heterointerfaces, which provides high capacitive contribution and rational Na⁺ adsorption energy. Furthermore, ZMSCN features dynamic heterostructures and vacancies evolution, with in-situ characterizations confirming charge transfer-controlled reaction kinetics and carbon matrix-dominated Na⁺ gradient diffusion, along with stable solid electrolyte interface (SEI) film ionic transport kinetics. Therefore, ZMSCN//NVP delivers an outstanding reversible capacity of 375.6 mAh g^-1 at 0.5 A g^-1 while maintaining 118.6 mAh g^-1 after 700 cycles at 5 A g^-1. This work provides fundamental insights into heterostructures engineering and vacancies modulation, demonstrating a viable pathway for developing practical anodes for SIBs.

2025-12-01·Nano-Micro Letters

Optimization Strategies of Na3V2(PO4)3 Cathode Materials for Sodium-Ion Batteries

Review

作者: Xu, Li ; Liu, Yu ; Hu, Jiawen ; Gao, Yanfeng ; Li, Xinwei ; Ding, Changsheng ; Liang, Qianqian

Abstract:

Na3V2(PO4)3 (NVP) has garnered great attentions as a prospective cathode material for sodium-ion batteries (SIBs) by virtue of its decent theoretical capacity, superior ion conductivity and high structural stability. However, the inherently poor electronic conductivity and sluggish sodium-ion diffusion kinetics of NVP material give rise to inferior rate performance and unsatisfactory energy density, which strictly confine its further application in SIBs. Thus, it is of significance to boost the sodium storage performance of NVP cathode material. Up to now, many methods have been developed to optimize the electrochemical performance of NVP cathode material. In this review, the latest advances in optimization strategies for improving the electrochemical performance of NVP cathode material are well summarized and discussed, including carbon coating or modification, foreign-ion doping or substitution and nanostructure and morphology design. The foreign-ion doping or substitution is highlighted, involving Na, V, and PO43− sites, which include single-site doping, multiple-site doping, single-ion doping, multiple-ion doping and so on. Furthermore, the challenges and prospects of high-performance NVP cathode material are also put forward. It is believed that this review can provide a useful reference for designing and developing high-performance NVP cathode material toward the large-scale application in SIBs.

项与奈韦拉平相关的新闻（医药）

2025-08-03

·抗体圈

儿童用长效注射剂研究进展

摘要近年来，我国儿童常见病发病率逐渐上升且低龄化日益显著。作为特殊人群，儿童用药与成人相比，除具有同适应证用药不同、剂量不同、辅料不同等特点以外，用药依从性差是影响其临床疗效的重要因素。与普通注射剂相比，儿童用长效注射剂可降低药物突释带来的副作用，并可大幅度减少注射次数，从而显著提高儿童患者依从性，提高临床疗效。长效注射剂应用于儿科具有显著优势。该文以药物和材料相互作用分类，综述儿童用长效注射剂研究进展，可为儿童用长效注射剂开发提供参考。_正文_我国儿童疾病如发育迟缓、哮喘、艾滋病、糖尿病、癌症等的发病率逐渐上升且低龄化趋势日益显著。2020年我国儿童人口占总人口的17.95%，儿童医药市场在总医药市场中所占份额却不到5%[1]，这远不能满足我国庞大的儿童用药需求。儿童作为特殊人群，其用药与成人相比，除具有同适应证用药不同、剂量不同、辅料不同等特点外，用药依从性差是影响临床疗效的重要因素[2]。长效注射剂是指通过单次注射给药，实现较长时间维持相对稳定血药浓度，从而起到缓释或控释作用的制剂[3]。与普通注射剂相比，应用于儿童的长效注射剂，可降低因药物突释带来的副作用，并可大幅度减少注射次数，显著提高患者依从性和临床疗效[4]。长效注射剂应用于儿童疾病方面具有显著优势。常用的药物长效递送技术有化学偶联、融合蛋白、单克隆抗体、微球、纳米晶、水凝胶等，见图1。本文按药物和材料相互作用进行分类，对儿童用长效注射剂的基础研究进展进行综述。图1 儿童用长效注射剂递送技术Fig.1 Long-acting injectable delivery techniques for children1化学偶联1.1 聚乙二醇(polyethylene glycol，PEG)修饰PEG修饰可通过降低肾脏过滤速度、减少蛋白酶降解和更好地模拟人体激素分泌特点，延长药物在体内的循环时间。PEG修饰制剂稳定性好，可提高药物生物相容性[5]。生长激素是儿童生长激素缺乏症(growth hormone deficiency，GHD)的主要治疗药物，需要每天注射。JINTROLONG(金赛增@)是一种PEG长效重组人生长激素(recombinant human growth hormone，rhGH)，由40kDa的PEG残基连接到rhGH上，使其具备长效缓释效果[6]。儿童Ⅲ期临床试验显示，与每天给予rhGH相比，每周使用JINTROLONG(金赛增@)身高增长速度更快，疗效和安全性相同[7]。非格司亭被广泛应用于预防实体癌或血液系统癌症化学治疗(化疗)所致中性粒细胞减少。曲培非格司亭和利培非格司亭是分别连接23kDa和20kDa分子量PEG的新型PEG化非格司亭。LEE等[8]和BELOGUROVA等[9]在临床评估试验中得出结论，曲培非格司亭终末半衰期>40h，利培非格司亭单次注射后药物滞留时间最长可达110h。二者对儿童具有较高的安全性，可提高儿童患者用药依从性，缩短住院时间。1.2 暂时连接(transient conjugation，TransCon)技术TransCon技术是指将药物通过连接子可逆地结合到长效载体形成前药，达到长效目的的技术。该前药在体内可以缓慢释放出活性药物，从而实现长效作用。软骨发育不全(achondroplasis，ACH)是一种最常见遗传性侏儒症，在新生儿中发病率为1/15000~1/77000。C型利钠肽(C-type natriuretic peptide，CNP)能从根源上治疗该病。人体天然CNP半衰期短，仅有2~3min，需要连续静脉输注使用，难以临床应用[10]。TransCon CNP和Lonapegsomatropin是2种通过TransCon技术得到的儿童用长效注射剂。TransCon CNP是一种新型CNP前药，通过可裂解接头偶联到PEG载体分子上，用于治疗儿童ACH。Lonapegsomatropin则是将rhGH由特定链接键链接到惰性甲氧基PEG载体上，用于治疗GHD。BREINHOLT等[11]证实，TransCon CNP在小鼠和非人灵长类动物模型中，半衰期长达120h，可每周给药1次缓慢释放药物。目前TransCon CNP在中国与全球其他地区同步开展Ⅱ期临床试验[12-13]。与rhGH半衰期约3h相比，Lonapegsomatropin半衰期约为25h[14]。美国食品药品管理局(Food and Drug Administration，FDA)于2021年秋季批准了Lonapegsomatropin，每周1次用于治疗体质量≥11.5kg、因内源性生长激素分泌不足导致生长缓慢的≥1岁儿童[15]。1.3 非共价结合白蛋白机制是将具有非共价白蛋白结合特性的脂肪酸与药物结合，来结合内源性白蛋白，从而延长药物半衰期[16]。德谷胰岛素由在地特胰岛素B链29号位点的赖氨酸上连接一个16碳脂肪二酸侧链得到，进入血液循环后，可与白蛋白可逆性结合，蛋白结合率>99%，进一步延缓到达靶组织的时间[17]。德谷胰岛素作用持续时间>42h，有望成为第3个被批准在中国上市的儿童长效胰岛素。Somapacitan是一种长效hGH类似物，该药将非共价白蛋白结合特性的脂肪酸通过烷基化与人生长激素结合，可每周给药1次[18]。2023年4月FDA扩大了Somapacitan适应证，批准其用于治疗≥2.5岁儿童GHD。1.4 化学修饰通过对药物进行酯化、制成难溶性盐、改变药物可溶pH值均可延长药物半衰期，形成长效注射药物。化学修饰策略可在最大限度不影响药物生物活性的情况下延长半衰期。有研究将抗精神病药物帕利哌酮酯化形成帕利培酮棕榈酸酯，肌内注射后缓慢地溶解为棕榈酸与帕利哌酮发挥药效，可实现6个月给药1次[19]。PETRIC等[20]的临床试验表明，帕利培酮棕榈酸酯在青少年患者中安全有效，且在临床效果、副作用和住院治疗方面都优于利培酮。苄星青霉素是青霉素的二苄基乙二胺盐，在注射部位缓慢释放并水解为青霉素，有效血药浓度可维持2~4周，用于预防儿童风湿热复发和控制链球菌感染流行[21]。甘精胰岛素是将人胰岛素A链21号位点的门冬氨酸替换成甘氨酸，在B链加上2个精氨酸残基得到的长效胰岛素，可溶性pH值变为4.0，皮下注射到中性pH条件后，形成细小沉淀[22]。这些微沉淀在较长时间里持续释放胰岛素单体，作用可持续30h，从而达到长效降糖效果。2物理亲和2.1 纳米晶纳米晶注射混悬剂利用难溶药物释放速度慢的机制，经皮下或深部肌内注射后可缓慢持续释放药物进入血液或淋巴循环，从而可形成长效注射剂。纳米晶可以解决微球载药量小的问题。2021年，有16万例儿童新发人类免疫缺陷病毒(human immunodeficiency virus，HIV)感染，占全部感染者总数的4%，但是却占到因该疾病死亡人数的15%[23]。长效注射剂在儿童各个年龄段预防和治疗HIV感染方面具有很大潜力[24]。卡博特韦/利匹韦林(cabotegravir/rilpivirine，Cabenuva)是针对HIV的首个长效注射疗法，是使用纳米晶技术制备的注射混悬剂。LOWENTHAL等[25]的临床研究发现，青少年注射卡博特韦或者利匹韦林具有高度接受和耐受性，有可能成为青少年HIV感染者的第一选择。2.2 微球微球具有良好的生物相容性，可通过结构修饰来调节药物释放动力学[26]，其通过皮下或肌内注射等方式进入人体后，聚合物材料在生理环境下会逐渐溶蚀降解，从而达到长效缓释效果。曲普瑞林微球和醋酸亮丙瑞林微球长效剂型在儿童中枢性性早熟(central precocious puberty，CPP)治疗中优势显著[27-29]。2024年7月9日，注射用双羟萘酸曲普瑞林微球的每6个月注射1次的剂型经中国国家药品监督管理局正式批准用于CPP的治疗，该药进一步延长了注射间隔，提高了儿童患者依从性。此外，市场上已有多种用于治疗儿童疾病的长效微球制剂。如用于治疗儿童2型糖尿病的艾塞那肽聚乳酸-羟基乙酸共聚物[poly(lactic-coglycolic acid)，PLGA]微球[30]，以及用于治疗儿童激素分泌过多的生长抑素长效制剂奥曲肽PLGA微球、兰瑞肽微球[31]以及用于GHD的微球制剂LB03002。相关临床试验表明，奥曲肽PLGA微球可实现每个月注射1次[32]，而每周注射1次0.5mg·kg-1LB03002与连续7d每天注射1次0.21mg·kg-1rhGH具有等同疗效[33]。但微球也存在一些问题，如突释现象、容易引发感染、蛋白质降解以及难以大规模生产等。DIANA等[34]将GH制成葡聚糖颗粒，并通过自组装封装到PLGA微球。葡聚糖可调节渗透压减少突释。相关药动学研究表明，该制剂表现出较小的早期突释，且可持续释放30d。该微球给药系统可能成为未来应用于临床的rhGH长效注射剂。2.3 聚合物纳米粒药物被包裹在聚合物基质中形成聚合物纳米粒，聚合物可以延缓药物降解，从而延长药物递送时间。眼外伤和随后的纤维变性视网膜并发症是造成儿童和年轻人失明的主要原因。UEDA等[35]建立了模拟挫伤和穿透伤的猪眼外伤模型，并在玻璃体内注射包载达沙替尼(dasatinib，Das)的PLGA纳米粒(Das-PLGA)注射液。结果表明，Das-PLGA可持续释放达沙替尼12d，显著减少早期纤维化视网膜变化。疫苗是预防传染类疾病和死亡的重要制剂，但许多疫苗必须注射多次才能起效，如疟疾疫苗。KANG等[36]合成了三甲基壳聚糖纳米粒，电荷表面可以负载不同阶段抗原，选用透明质酸盐作为表面保护涂层，防止外层蛋白质立即释放和降解，将抗原的释放时间控制在几天到几个月，达到持久产生保护性免疫反应的目的。与传统疟疾疫苗相比，2次注射间隔可长达4周。开发此类疫苗对于在儿童中减少疟疾这一类致命病毒至关重要。2.4 脂质体多囊脂质体通过外层囊泡的逐渐降解实现药物的持续释放。布比卡因是临床常用局部麻醉镇痛剂，其普通注射剂不能满足儿童术后长时间镇痛需要，因此需要具有长效缓释作用的注射剂。布比卡因多囊脂质体镇痛时间长达72h，可满足手术疼痛控制时间。目前脂质体布比卡因适用于多种儿童术后疼痛控制[37-38]，具有良好安全性和疗效。2.5 包合物奈韦拉平(nevirapine，NVP)作为抗逆转录病毒治疗药物，可阻断HIV母婴传播。YANG等[39]开发了NVP长效注射形式，将NVP与聚己内酯(polycaprolactone，PCL)制备成结晶包合物。与纯NVP晶体相比，NVP-PCL包合物晶体溶解度降低至原来的1/4，溶解速度减慢，并在体温下pH值7.4的PBS溶液中稳定至少6周，表现为较强的缓释特性。2.6 水凝胶水凝胶多孔结构和水溶性有利于药物负载，药物释放取决于水凝胶溶胀和药物从聚合物中的扩散，因局部持续药物释放而被广泛用作长效制剂。2.6.1 整体水凝胶梗阻性肾病是儿童肾脏疾病的主要原因，可通过局部和持续输送白细胞介素-10(interleukin10，IL-10)和抗转化生长因子β(anti transforming growth factor-β，anti-TGF-β)治疗。RODELL等[40]设计可注射透明质酸水凝胶，将IL-10、anti-TGF-β结合在一起，降解试验表明，其体外释放时间长达3周，为梗阻性肾病的治疗提供了新的长效治疗策略。视网膜母细胞瘤是儿童最常见的原发性眼恶性肿瘤，HUO等[41]和TAICH等[42]制备了负载拓扑替康(topotecan，TPT)的聚己内酯-PEG-聚己内酯(PCL PEG-PCL)嵌段共聚物水凝胶以及温度敏感水凝胶。前者体外释放曲线显示TPT从嵌段共聚物水凝胶持续释放长达7d。后者在接近体温时，可在视网膜母细胞瘤肿瘤组织中缓慢释放TPT，持续释放>400h。二者在未来转化为临床将具有延长治疗效果、降低患者玻璃体注射频次的优势，有望成为眼内视网膜母细胞瘤治疗的新策略。同样，温度敏感水凝胶在骨肉瘤(osteosarcoma，OS)中也有所应用。OS是一种严重的原发性骨恶性肿瘤，患者多为儿童和青少年。SI等[43]和SHAN等[44]分别制备了包载多柔比星和顺铂的PLGA-PEG PLGA三嵌段共聚物水凝胶和包载甲氨蝶呤和阿伦磷酸钠的聚(L-缬氨酸)(poly-L-valine，PLV)水凝胶。2种水凝胶可在适当温度下经历溶胶-凝胶转变持续释放药物。体外释放结果显示，PLGA-PEG-PLGA共聚物可实现10d持续释放多柔比星和顺铂。PLV水凝胶在第1周内小部分降解，第2周水凝胶体积减少到50%，4周后水凝胶降解完全，也呈现出缓释特点。二者在OS治疗中具有潜在应用价值。2.6.2 水凝胶-微球较大的水凝胶微球粒径相较于较小的水凝胶微球粒径具有更长药物释放时间，且药物与水凝胶之间分子相互作用可以延缓药物从水凝胶微球中释放。万古霉素是治疗儿童慢性骨髓炎的“最后一线药物”，需要长期、大剂量给药，这可能导致耐药性、肾毒性等多种副作用。ZHANG等[45]以丝素蛋白为药物载体，装载万古霉素形成药物微球，然后使用丝素蛋白纳米纤维溶液制备可注射水凝胶作为药物的载体。万古霉素从水凝胶中持续释放达25d，且对大肠埃希菌和金黄色葡萄球菌均有较强抗菌活性，抗菌时间长达10d。此外，QIANG等[46]进一步开发了一种载有血管内皮生长因子、胰岛素样生长因子-1(insulin like growth factor-1，IGF-1)和贝伐单抗的内外双层PLGA微球水凝胶制剂，用于促进儿童受伤后软骨分化和再生以及抑制骨桥形成。体外释放试验表明，约80%贝伐单抗在第1周被释放，而只有少量IGF-1被释放。在接下来的2周内，IGF-1释放量稳步增加，该制剂表现出良好的缓释特性。同样机制的有长春新碱葡聚糖微球与壳聚糖-β-甘油磷酸凝胶协同疗法制剂[47]。该制剂可克服硫酸长春新碱血清半衰期短(12min)，给药频率高(每平方米体表面积1.4mg，每周注射1次，连续4周)和广泛的蛋白质结合的缺点。制剂包载的药物释放维持长达30d，在治疗儿童急性淋巴细胞白血病、霍奇金淋巴瘤等实体瘤方面具有更广阔前景。3生物相互作用3.1 融合蛋白融合蛋白是指利用基因工程等技术将某种具有生物学活性的功能蛋白分子与其他天然蛋白(融合伴侣)融合产生的新型蛋白[48]。融合蛋白技术依靠融合伴侣的长效机制和增加分子大小来延长半衰期。根据融合伴侣不同，融合蛋白分为可结晶片段(fragment crystallizable，Fc)融合蛋白、白蛋白融合蛋白、C-末端肽(C-Terminal peptide，CTP)融合蛋白等。融合蛋白类药物的融合伴侣结构简单，具有免疫原性低、变态反应少的特点。Fc结构域可增大药物分子量，减少肾脏排泄，并且因其新生Fc受体具有再循环的能力从而延长药物血液循环时间。SHAPIRO[49]进行的临床研究表明，将重组凝血因子Ⅷ或IX与Fc融合以治疗儿童血友病，可实现每周注射1次。Rilonacept由人IL-1受体胞外区与人免疫球蛋白G1(immunoglobulin G1，IgG1)的Fc段融合而成，其半衰期可达8d[50]。FDA批准其用于治疗≥12岁儿童复发性心包炎和冷吡啉相关周期性综合征。还有学者使用可延长半衰期的白蛋白连接凝血因子Ⅸ形成重组融合蛋白(rIX-FP)，后者较rFIX药动学特征改善，半衰期延长约5倍[51]。Somatrogon(MOD-4023)是一种利用人绒毛膜促性腺激素β亚基羧基末端肽修饰的长效hGH，该肽可保护蛋白质免受蛋白酶降解，半衰期延长2~4倍[52]。MORI等[53]和HERSHKOVITZ等[54]的临床试验表明，与每日1次给予生长激素相比，每周给予Somatrogon1次治疗儿童GHD具有更好效果。3.2 单克隆抗体应用于儿童注射剂的单克隆抗体主要集中于呼吸系统疾病。西加韦单抗和替沙格韦单抗(cilgavimab/tixagevimab)是2种重组人免疫球蛋白G1k链单克隆抗体，其在抗体的Fc区进行氨基酸置换，通过影响抗体与免疫系统中其他分子的相互作用来延长抗体半衰期[55]。与传统抗体相比，半衰期可延长>3倍，成人和>12岁青少年(体质量≥40kg)单次给药后长达12个月有效。注射用奥马珠单抗也为重组人源化单克隆抗体，为抗免疫球蛋白E靶向生物制剂，适用于≥6岁患有中至重度持续性过敏性哮喘的儿童，每2~4周注射1次可维持疗效[56]。呼吸道合胞病毒(respiratory syncytial virus，RSV)是引起婴儿下呼吸道感染的主要原因[57]。单克隆抗体可作为疫苗替代品预防RSV感染。Nirsevimab是一种包含Fc突变片段且具有较长半衰期(平均59.3d)的RSV单克隆抗体[58]，临床数据表明，单剂量肌内注射Nirsevimab可实现婴儿至少5个月预防RSV感染[59]。2023年7月，首个用于预防婴幼儿RSV疾病的长效单克隆抗体Nirsevimab经FDA获批上市。目前Nirsevimab已在国内开展Ⅲ期临床试验。儿童用长效注射剂相关临床研究进展见表1。4展望与成人相比，儿童患者因年龄小、自我管理能力有限，对于一些慢性疾病(如GHD)往往需要长期甚至终身用药。频繁给药会给患儿带来不便与痛苦，且患儿依从性不足导致的治疗中断还会使病情恶化加重。长效注射剂则提供了更便捷的治疗方案，它通过延长药物作用时间，降低了治疗中断风险，提高了依从性[60]。本文全面综述了当前儿童用长效注射剂基础研究方面的进展情况，同时对其临床研究进展进行了系统总结。目前已上市的儿童用长效注射剂有生长激素、Cilgavimab/Tixagevimab、曲普瑞林微球制剂和卡博特韦/利匹韦林注射液Cabenuva等。此外，一部分长效药物已经进入Ⅲ期临床试验。很多学者在儿童疾病(如癌症、梗阻性肾病和炎症性疾病)方面进行了长效制剂的基础研究，以期推动长效注射剂的临床转化。儿童用长效注射剂在提升治疗依从性的同时，也面临一系列挑战和问题。就常见的儿童用长效制剂辅料而言，以PEG为例，其代谢产物会引发诸多不良状况，如导致酸中毒和高钙血症。融合蛋白可能出现新的抑制性抗体，这无疑给治疗带来了潜在风险。而在微球长效制剂中，形成微球的聚合物多孔表面使封装药物容易扩散而导致药物突释问题。另外，水凝胶长效制剂存在生物相容性差的问题，纳米晶长效制剂在给药后的体内过程和生物药剂学方面研究尚不充分。儿童用长效注射剂在提高依从性的同时，因可能导致非生理特性反应在体内产生相关不良反应，因而疗效、安全性方面存在极大挑战。而且其在制造及商业化方面也存在诸多问题。面对这些挑战，未来的发展方向应聚焦于精密设计药物结构及服用剂量，提供个性化基质与药物处方，从而研发出不影响药物疗效及稳定性、满足不同儿童用药需求的长效注射剂。在医学日益发达的背景下，基于儿童这一特殊人群的长效注射剂的发展具有广阔前景。PEG修饰、TransCon技术、非共价结合白蛋白、单克隆抗体、微球机制可应用于长效蛋白类药物。而包合物、纳米晶剂型可应用于长效化学药物。水凝胶、化学修饰机制在长效化药、蛋白类药物方面均有所应用。未来，长效注射剂有望在儿童癌症等重大疾病、哮喘等慢性呼吸系统疾病、生长发育迟缓等内分泌系统疾病以及疫苗研发等方面成为热点。参考文献详见《医药导报》 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2025-07-17

·米内网

华海药业强势突围！领跑4大百亿品类，16款新药抢攻2300亿市场，9个产品迎战第十一批集采

精彩内容7月15日，万众期待的#第十一批集采药品目录终于出炉，涉及55个品种，华海药业将有9个产品迎战。7月以来，华海药业陆续迎来多个喜讯，1类新药HB0056注射液启动I期临床试验、两个新品琥珀酸美托洛尔缓释片和盐酸尼卡地平注射液获批上市，公司的实力正不断提升。近四年，华海药业每年均投入超10亿元用于创新研发，公司的首款生物药新药正在冲刺上市，19款新药（生+化）积极推进临床，未来可期。近四年研发投入均超10亿，首款生物药新药正冲刺米内网数据显示，华海药业的生物药1类新药HB0056注射液于7月1日启动哮喘I期临床，该新药是一款双特异性抗体，能靶向TSLP和IL-11两个靶点。近几年，华海药业的新药矩阵越来越强大，并逐渐进入收获期，公司的阿达木单抗注射液3.3类新药上市申请正在审评审批中，米内网预测将在今年年底获批。阿达木单抗注射液将成为华海药业首款上市的生物药，具有积极意义，2024年在中国三大终端六大市场（统计范围见文末），生物药的销售规模已超过2300亿元。图1：华海药业的阿达木单抗注射液审评情况来源：米内网中国申报进度（MED）数据库据公司年报数据显示，2021-2024年华海药业的研发投入合计分别为11.06亿元、12.02亿元、11.70亿元、12.00亿元，毫不吝惜的付出逐渐换来了丰硕的成果，目前公司有12个生物药新药和3个化药新药正在开展临床，1个生物药新药和1个化药新药已批准临床，2个生物药新药申报临床在审。表1：华海药业部分在研的重磅新药来源：米内网中国临床试验数据库15个生物药新药火力全开，目前进展最快的是HB0017注射液和贝伐珠单抗注射液。1类新药HB0017注射液是以白介素-17A为靶点的单克隆抗体，该新药银屑病III期临床在2024年2月启动、成人活动性强直性脊柱炎III期临床在2025年5月启动。1类新药注射用HB0043在今年5月提交临床申请，目前正在审评审批中，该新药是全球首款靶向IL-17A与IL-36R的双抗药物，将为单因子阻断疗法存在局限性的免疫介导的炎症性皮肤病和纤维化疾病的靶向治疗提供新的思路。领跑5大热销品类市场，10个亿级产品亮眼截至目前，华海药业已上市的药品制剂超过100个（按产品名统计，不含原料药），其中化学药占了101个、中成药占了5个。2024年在中国三大终端六大市场，华海药业有10个产品销售额在1亿元以上，均为化学药。表2：2024年华海药业在中国三大终端六大市场的过亿产品来源：米内网格局数据库华海药业旗下长兴制药的复方甲氧那明胶囊2021-2024年在中国三大终端六大市场连续增长了2.80%、10.52%、100.64%、8.62%，2024年销售额接近2.9亿元，2025年Q1再有25.02%的增长，首次成为阻塞性气管疾病用药（化+生）市场TOP20品牌。图2：华海药业的磷酸奥司他韦胶囊销售情况（单位：万元）来源：米内网格局数据库华海药业在2022年7月拿下了磷酸奥司他韦胶囊，随后中标第七批国采，在集采的助力下，该品牌在中国三大终端六大市场一路飙涨，2023年突破1.5亿元，2024年涨至接近1.8亿元，2025年Q1已拿下1.07亿元的销售成绩，全年有望再创新高。#华海药业积极拓展产品领域并持续耕耘，2025年Q1在中国三大终端六大市场已挺进5个亚类市场TOP20集团（一级）之列，领军优势亮眼。高血压用药2024年的整体规模在630亿元以上，2025年Q1华海药业蝉联TOP7集团，畅销产品包括了厄贝沙坦氢氯噻嗪片、厄贝沙坦片、氯沙坦钾片、缬沙坦片等。精神兴奋药2024年的整体规模在160亿元以上，2025年Q1华海药业蝉联TOP7集团，畅销产品包括了盐酸帕罗西汀片、盐酸舍曲林片、盐酸多奈哌齐片、草酸艾司西酞普兰片等。图3：华海药业的全身用抗病毒药销售及市场份额情况（单位：万元）来源：米内网格局数据库全身用抗病毒药（化+生）2024年的整体规模在220亿元以上，2025年Q1华海药业一跃成为了TOP10集团，近几年公司该类药物的销售额持续暴涨，畅销产品包括了磷酸奥司他韦胶囊、依非韦伦片、奈韦拉平片。阻塞性气管疾病用药（化+生）2024年的整体规模涨至275亿元，2025年Q1华海药业升上TOP16集团，畅销产品是复方甲氧那明胶囊。全身用抗真菌药2024年的整体规模在70亿元以上，2025年Q1华海药业为TOP10集团，畅销产品包括了伏立康唑片和注射用伏立康唑。2025年已拿下16个新产品，过评产品将突破100个7月8日，华海药业再有两个高血压用药新品获批上市，包括了琥珀酸美托洛尔缓释片和盐酸尼卡地平注射液，将助力公司巩固高血压用药市场的领军地位。表3：2025年至今华海药业获批的新产品来源：米内网中国上市药品（MID）数据库2025年至今，华海药业已累计拿下了16个新产品（按产品名统计），其中公司的拳头领域高血压用药占了5个。值得注意的是，尼麦角林片是公司首款脑血管治疗用药，标志华海药业成功入局160亿市场。表4：华海药业报产在审的仿制药新品来源：米内网中国申报进度（MED）数据库2023年至今，华海药业及子公司还有39个高端仿制药报产在审，将在抗贫血制剂、全身用抗细菌药、胃肠解痉药及抗胆碱药和胃动力药、心脏病治疗用药、血脂调节剂、止泻药及肠道抗炎/抗感染药、止血药、治疗便秘的药物等12个亚类市场迎来新突破。随着新品陆续获批，华海药业过评产品数量也在逐步增加，截至2025年7月16日，公司已过评（含视同过评）的产品达97个，全年有望突破100个。华海药业积极参与国家集中带量采购，前十批国采（不含第六批胰岛素专项）已累计中标25个产品，包括了氯沙坦钾片、利培酮片、赖诺普利片、福辛普利钠片、厄贝沙坦氢氯噻嗪片、厄贝沙坦片、缬沙坦片、伏立康唑片、罗库溴铵注射液、盐酸多奈哌齐片、安立生坦片、阿立哌唑片、奥氮平口崩片、奥美沙坦酯氢氯噻嗪片、利伐沙班片、阿立哌唑口崩片、氯沙坦钾氢氯噻嗪片、磷酸奥司他韦胶囊、西格列汀二甲双胍片(Ⅱ)、非洛地平缓释片、注射用伏立康唑、赛洛多辛胶囊、甲磺酸雷沙吉兰片、盐酸舍曲林片、盐酸帕罗西汀片。表5：华海药业拟参与第十一批集采的产品来源：米内网格局数据库7月15日，上海阳光医药采购网发布《关于开展第十一批国家组织药品集中采购相关药品信息填报工作的通知》，55个品种拟纳入第十一批集采，华海药业将有9个产品参与激战。2024年在中国三大终端六大市场，达格列净口服常释剂型的销售规模在70亿元以上，多巴丝肼口服常释剂型也卖出超10亿元，华海药业最终能拿下怎样的成绩单，我们拭目以待。资料来源：米内网数据库、公司年报及公告、上海阳光医药采购网等注：米内网《中国三大终端六大市场药品竞争格局》，统计范围是：城市公立医院和县级公立医院、城市社区中心和乡镇卫生院、城市实体药店和网上药店，不含民营医院、私人诊所、村卫生室，不含县乡村药店；上述销售额以产品在终端的平均零售价计算。统计截至7月16日，欢迎指正！免责声明：本文仅作医药信息传播分享，并不构成投资或决策建议。本文为原创稿件，转载文章或引用数据请注明来源和作者，否则将追究侵权责任。投稿及报料请发邮件到872470254@qq.com稿件要求详询米内微信首页菜单栏商务及内容合作可联系QQ：412539092【分享、点赞、在看】点一点不失联哦

临床3期申请上市上市批准临床1期

2025-07-08

·merck.com

Merck to Present New Data Highlighting Research Advancements Across its HIV Prevention and Treatment Pipeline at IAS 2025

July 8, 2025 6:45 am ET RAHWAY, N.J.--(BUSINESS WIRE)-- Merck (NYSE: MRK), known as MSD outside of the United States and Canada, announced today that new data from its research pipeline for HIV prevention and treatment will be presented at the 13th International AIDS Society Conference on HIV Science (IAS 2025) taking place July 13-17, 2025, in Kigali, Rwanda. Merck will share new scientific findings from its HIV clinical development programs, including Phase 2 data on the safety and pharmacokinetics of MK-8527, an investigational, novel nucleoside reverse transcriptase translocation inhibitor (NRTTI), dosed orally once monthly, in development for the prevention of HIV as pre-exposure prophylaxis (PrEP). HIV clinical data presented at IAS 2025 from three Phase 3 trials (P051: NCT05631093; P052: NCT05630755; P054: NCT05766501) will examine the impact of preexisting resistance-associated mutations (RAMs) in proviral DNA on the virologic response to doravirine/islatravir (DOR/ISL), with a primary focus on M184I/V in proviral DNA. Data will also be presented on the clinical development program for a once-weekly oral combination of islatravir and ulonivirine (ISL/ULO) for the treatment of adults with HIV-1 infection. Data from two Phase 1 trials evaluating the safety and tolerability of weekly ulonivirine and drug interactions between islatravir and ulonivirine dosed weekly in adults without HIV and a Phase 2b dose-ranging study utilizing a higher (20mg) dose of islatravir and 3 doses of ulonivirine in treatment naive adults living with HIV-1 will be presented. Based on results from these trials and pharmacokinetic modeling that will also be presented, a once-weekly oral combination of islatravir (2mg) and ulonivirine (200mg) (MK-8591B) is moving forward in clinical development. “As we continue to advance our HIV research, we are excited to present data from across our HIV pipeline at IAS 2025, including new data from our nucleoside reverse transcriptase translocation inhibitors development programs,” said Dr. Elizabeth Rhee, vice president, global clinical development, Merck Research Laboratories. “With daily, weekly and monthly oral regimens in development, we aim to offer choices that can help address the evolving needs of individuals living with or impacted by HIV.” Select abstracts in the IAS 2025 program include: Abstract Title and Author Date HIV PREVENTION Safety and Pharmacokinetics of Once-Monthly MK-8527: a Phase 2 Study in Adults at Low Risk of HIV-1 Exposure, Mayer, K, et al. Late-Breaker Oral Presentation Wednesday, July 16, 2025 (15:00 – 16:00 CAT) HIV TREATMENT Switching to Doravirine/Islatravir (100mg/0.25mg) Once Daily Maintained Viral Suppression in the Presence of Archived M184I/V Resistance-Associated Mutations in Proviral DNA, Diamond, T, et al. Poster Session Wednesday, July 16, 2025 (12:15 – 13:15 CAT) A Double-Blind, Active-Controlled, Phase 2b Study to Evaluate the Efficacy and Safety of Ulonivirine in Combination with Islatravir in Virologically Suppressed Adults Living With HIV-1, Molina, J.M., et al. (*) Oral Presentation ART Strategies Tuesday, July 15, 2025 (10:45 – 11:45 CAT) A Double-Blind Placebo-Controlled, Phase 1 Study to Evaluate Extended Multiple Dosing of Ulonivirine (MK-8507) in Adults Without HIV, Nussbaum, J, et al. Virtual Poster An Open-Label Phase 1 Study to Evaluate Drug Interactions Between Multiple Weekly Doses of Ulonivirine (MK-8507) and Single Doses of Islatravir in Adults Without HIV, Nussbaum, J, et al. Virtual Poster Phase 2 Once-Weekly Dose Optimization for Ulonivirine (MK-8507) in Combination with Islatravir (2mg), Pham, M, et al. Virtual Poster (*) Previous ulonivirine development program utilizing a higher (20mg) dose of islatravir. This year at IAS, Merck will host a policy symposium “Harnessing the Private Sector to Deliver HIV Prevention” on Tuesday, July 15, from 18:00 – 19:30 CAT. Merck will also host a medical symposium “Let’s Talk About It – Practical Case Discussions” on Wednesday, July 16, from 12:15 – 13:15 CAT, which will cover critical considerations when treating HIV today, as well as a deep dive into the DOR/ISL resistance profile based on Phase 3 data. Both events will be open to all registered attendees, virtually and in-person. Separately, Merck will be hosting a virtual investor event where scientific and commercial leaders will give an overview of the company’s advancing research pipeline in HIV treatment and prevention on Thursday, July 17, at 9:00AM ET. Investors, analysts, members of the media, and the general public are invited to listen to a webcast of the presentation at this weblink. For more details about Merck’s clinical development program in HIV treatment and prevention, click here. Merck’s Commitment to HIV For more than 35 years, Merck has been committed to scientific research and discovery in HIV leading to scientific breakthroughs that have helped change HIV treatment. Our work has helped pioneer the development of new options across multiple drug classes to help those impacted by HIV. Today, we are developing a series of antiviral options designed to help people manage their HIV and to help prevent HIV, with the goal of reducing the growing burden of infection worldwide. We want to ensure people are not defined by HIV, and our work focuses on transformational innovations, collaborations with others in the global HIV community, and access initiatives aimed at helping to end the HIV epidemic for everyone. Indications and usage for PIFELTRO® (doravirine) and DELSTRIGO® (doravirine, lamivudine, and tenofovir disoproxil fumarate) in the U.S. PIFELTRO is indicated in combination with other antiretroviral (ARV) agents for the treatment of HIV-1 infection in adult patients with no prior ARV treatment history or to replace the current ARV regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable ARV regimen with no history of treatment failure and no known substitutions associated with resistance to doravirine. DELSTRIGO is indicated as a complete regimen for the treatment of HIV-1 infection in adult patients with no prior ARV treatment history or to replace the current ARV regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable ARV regimen with no history of treatment failure and no known substitutions associated with resistance to the individual components of DELSTRIGO. Selected Safety Information Warning: Posttreatment Acute Exacerbation of Hepatitis B Virus (HBV) for DELSTRIGO All patients with HIV-1 should be tested for the presence of HBV before initiating ARV therapy. Severe acute exacerbations of HBV have been reported in people with concomitant HIV-1 and HBV who have discontinued products containing lamivudine or tenofovir disoproxil fumarate (TDF), which are components of DELSTRIGO. Patients coinfected with HIV-1 and HBV who discontinue DELSTRIGO should be monitored with both clinical and laboratory follow-up for at least several months after stopping DELSTRIGO. If appropriate, initiation of anti-HBV therapy may be warranted. Contraindications PIFELTRO and DELSTRIGO are contraindicated when coadministered with drugs that are strong cytochrome P450 (CYP)3A enzyme inducers (including the anticonvulsants carbamazepine, oxcarbazepine, phenobarbital, and phenytoin; the androgen receptor inhibitor enzalutamide; the antimycobacterials rifampin and rifapentine; the cytotoxic agent mitotane; and the herbal product St. John’s wort (Hypericum perforatum)), as significant decreases in doravirine plasma concentrations may occur, which may decrease the effectiveness of DELSTRIGO and PIFELTRO. DELSTRIGO is contraindicated in patients with a previous hypersensitivity reaction to lamivudine. Warnings and Precautions Severe Skin Reactions Severe skin reactions, including Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), have been reported during the postmarketing experience with doravirine-containing regimens. Discontinue PIFELTRO or DELSTRIGO, and other medications known to be associated with severe skin reactions, immediately if a painful rash with mucosal involvement or a progressive severe rash develops. Clinical status should be closely monitored, and appropriate therapy should be initiated. New or Worsening Renal Impairment Renal impairment, including cases of acute renal failure and Fanconi syndrome, have been reported with the use of TDF. DELSTRIGO should be avoided with concurrent or recent use of a nephrotoxic agent (eg, high-dose or multiple NSAIDs). Cases of acute renal failure after initiation of high-dose or multiple NSAIDs have been reported in people living with HIV with risk factors for renal dysfunction who appeared stable on TDF. Prior to or when initiating DELSTRIGO, and during treatment, assess serum creatinine, estimated creatinine clearance, urine glucose, and urine protein in all patients. In patients with chronic kidney disease, also assess serum phosphorus. Discontinue DELSTRIGO in patients who develop clinically significant decreases in renal function or evidence of Fanconi syndrome. Discontinue DELSTRIGO if estimated creatinine clearance declines below 50 mL/min. Bone Loss and Mineralization Defects In clinical trials in adults living with HIV, TDF was associated with slightly greater decreases in bone mineral density (BMD) and increases in biochemical markers of bone metabolism. Serum parathyroid hormone levels and 1,25 Vitamin D levels were also higher. Cases of osteomalacia associated with proximal renal tubulopathy have been reported with the use of TDF. The effects of TDF-associated changes in BMD and biochemical markers on long-term bone health and future fracture risk in adults are unknown. Immune Reconstitution Syndrome Immune reconstitution syndrome can occur, including the occurrence of autoimmune disorders with variable time to onset, which may necessitate further evaluation and treatment. Drug Interactions Because DELSTRIGO is a complete regimen, coadministration with other antiretroviral medications for the treatment of HIV-1 infection is not recommended. Coadministration of PIFELTRO with efavirenz, etravirine, or nevirapine is not recommended. If DELSTRIGO is coadministered with rifabutin, take one tablet of DELSTRIGO once daily, followed by one tablet of doravirine (PIFELTRO) approximately 12 hours after the dose of DELSTRIGO. If PIFELTRO is coadministered with rifabutin, increase PIFELTRO dosage to one tablet twice daily (approximately 12 hours apart). Consult the full Prescribing Information prior to and during treatment for more information on potential drug-drug interactions. Dosage and Administration/Specific Populations Renal Impairment Because DELSTRIGO is a fixed-dose combination tablet and the dosage of lamivudine and TDF cannot be adjusted, DELSTRIGO is not recommended in patients with estimated creatinine clearance less than 50 mL/min. Adverse Reactions The most common adverse reactions with DELSTRIGO (incidence ≥5%, all intensities) were dizziness (7%), nausea (5%), and abnormal dreams (5%). The most common adverse reactions with PIFELTRO (incidence ≥5%, all intensities) were nausea (7%), dizziness (7%), headache (6%), fatigue (6%), diarrhea (6%), abdominal pain (5%), and abnormal dreams (5%). By week 96 in DRIVE-FORWARD, 2% of adult participants in the PIFELTRO group and 3% in the darunavir+ritonavir (DRV+r) group had adverse events leading to discontinuation of study medication. By week 96 in DRIVE-AHEAD, 3% of adult participants in the DELSTRIGO group and 7% in the efavirenz (EFV)/emtricitabine (FTC)/TDF group had adverse events leading to discontinuation of study medication. In DRIVE-FORWARD, mean changes from baseline at week 48 in LDL-cholesterol (LDL-C) and non-HDL-cholesterol (non-HDL-C) were pre-specified. LDL-C: -4.6 mg/dL in the PIFELTRO group vs 9.5 mg/dL in the DRV+r group. Non-HDL-C: -5.4 mg/dL in the PIFELTRO group vs 13.7 mg/dL in the DRV+r group. The clinical benefits of these findings have not been demonstrated. In DRIVE-AHEAD, mean changes from baseline at week 48 in LDL-C and non-HDL-C were pre-specified. LDL-C: -2.1 mg/dL in the DELSTRIGO group vs 8.3 mg/dL in the EFV/FTC/TDF group. Non-HDL-C: -4.1 mg/dL in the DELSTRIGO group vs 12.7 mg/dL in the EFV/FTC/TDF group. The clinical benefits of these findings have not been demonstrated. In DRIVE-SHIFT, mean changes from baseline at week 24 in LDL-C and non-HDL-C were pre-specified. LDL-C: -16.3 mg/dL in the DELSTRIGO group vs -2.6 mg/dL in the PI + ritonavir group. Non-HDL-C: -24.8 mg/dL in the DELSTRIGO group vs -2.1 mg/dL in the PI + ritonavir group. The clinical benefits of these findings have not been demonstrated. In DRIVE-AHEAD, neuropsychiatric adverse events were reported in the three pre-specified categories of sleep disorders and disturbances, dizziness, and altered sensorium. Twelve percent of adult participants in the DELSTRIGO group and 26% in the EFV/FTC/TDF group reported neuropsychiatric adverse events of sleep disorders and disturbances; 9% in the DELSTRIGO group and 37% in the EFV/FTC/TDF group reported dizziness; and 4% in the DELSTRIGO group and 8% in the EFV/FTC/TDF group reported altered sensorium. The safety of DELSTRIGO in virologically-suppressed adults was based on week 48 data from participants in the DRIVE-SHIFT trial. Overall, the safety profile in virologically-suppressed adult participants was similar to that in participants with no ARV treatment history. Serum ALT and AST Elevations: In the DRIVE-SHIFT trial, 22% and 16% of participants in the immediate switch group experienced ALT and AST elevations greater than 1.25 X ULN, respectively, through 48 weeks on DELSTRIGO. For these ALT and AST elevations, no apparent patterns with regard to time to onset relative to switch were observed. One percent of participants had ALT or AST elevations greater than 5 X ULN through 48 weeks on DELSTRIGO. The ALT and AST elevations were generally asymptomatic, and not associated with bilirubin elevations. In comparison, 4% and 4% of participants in the delayed switch group experienced ALT and AST elevations of greater than 1.25 X ULN through 24 weeks on their baseline regimen. Pregnancy/Breastfeeding There is a pregnancy exposure registry that monitors pregnancy outcomes in individuals exposed to PIFELTRO or DELSTRIGO during pregnancy. Healthcare providers are encouraged to register patients by calling the Antiretroviral Pregnancy Registry (APR) at 1-800-258-4263. Inform individuals with HIV-1 infection of the potential risks of breastfeeding, including: (1) HIV-1 transmission (in HIV-1–negative infants), (2) developing viral resistance (in HIV-1–positive infants), and (3) serious adverse reactions in a breastfed infant similar to those seen in adults. About Merck At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world – and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit www.merck.com and connect with us on X (formerly Twitter), Facebook, Instagram, YouTube and LinkedIn. Forward-Looking Statement of Merck & Co., Inc., Rahway, N.J., USA This news release of Merck & Co., Inc., Rahway, N.J., USA (the “company”) includes “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the company’s management and are subject to significant risks and uncertainties. There can be no guarantees with respect to pipeline candidates that the candidates will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements. Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the company’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the company’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions. The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s Annual Report on Form 10-K for the year ended December 31, 2024 and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov). Please see Prescribing Information for PIFELTRO (doravirine) at: https://www-merck-com.libproxy1.nus.edu.sg/product/usa/pi_circulars/p/pifeltro/pifeltro_pi.pdf and Patient Information for PIFELTRO at: https://www-merck-com.libproxy1.nus.edu.sg/product/usa/pi_circulars/p/pifeltro/pifeltro_ppi.pdf Please see Prescribing Information for DELSTRIGO (doravirine, lamivudine, and tenofovir disoproxil fumarate) at: https://www-merck-com.libproxy1.nus.edu.sg/product/usa/pi_circulars/d/delstrigo/delstrigo_pi.pdf and Patient Information for DELSTRIGO at: https://www-merck-com.libproxy1.nus.edu.sg/product/usa/pi_circulars/d/delstrigo/delstrigo_ppi.pdf Media Contacts: Julie Cunningham, (617) 519-6264 Deb Wambold, (215) 779-2234 Investor Contacts: Peter Dannenbaum, (732) 594-1579 Steven Graziano, (732) 594-1583

临床2期临床结果临床1期临床3期

100 项与奈韦拉平相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D00435	奈韦拉平	J05AG01	DB00238

研发状态

批准上市

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适应症	国家/地区	公司	日期
HIV感染	美国	Boehringer Ingelheim Pharmaceuticals, Inc.	1996-06-21

未上市

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适应症	最高研发状态	国家/地区	公司	日期
获得性免疫缺陷综合征	临床3期	美国	Boehringer Ingelheim GmbH	2001-08-31
丙型肝炎	临床阶段不明	西班牙	Boehringer Ingelheim GmbH	2011-01-01
慢性丙型肝炎	临床阶段不明	西班牙	Boehringer Ingelheim GmbH	2011-01-01

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT02140255 (Pubmed \| Lancet HIV) 人工标引	临床1/2期	HIV感染	438	Nevirapine	築願鑰積蓋築網顧襯齋(簾鏇憲夢鑰鬱繭範構蓋) = 範衊壓壓觸顧淵鹹顧獵餘簾築淵廠憲鏇顧獵鹹 (鏇獵積製製選窪醖窪淵, 86 ~ 93) 更多	积极	2021-03-01
NCT01061151 (PROMISE, Pubmed \| PLoS One)	临床3期	-	2,444	Maternal antiretroviral therapy (mART)	壓構鹽醖觸淵構構築衊(膚鑰廠鹹淵積觸鬱築膚) = 艱繭餘構願簾鬱廠網衊築餘簾壓鬱鏇衊壓餘艱 (鹹範餘襯獵遞壓選遞餘, ( ~ 0.18, 0.07))	-	2021-01-01
				Infant Nevirapine prophylaxis (iNVP)	-
NCT00978068 (PROMOTE-PEDS, CTgov)	临床3期	HIV感染 \| 疟疾	176	LPV (Group 1: LPV/r + 2 NRTIs)	選鹹餘憲艱鑰觸鑰鏇鬱 = 齋選醖簾鑰鏇鏇淵網餘鹽鑰鏇鹹構蓋鏇遞觸蓋 (構齋廠構夢淵夢艱獵觸, 鹹製醖鹽鹹醖鏇獵醖餘 ~ 鑰餘積艱蓋襯鑰憲願簾)	-	2018-12-28
				Efavirenz (EFV)+Nevirapine (NVP) (Group 2: Nevirapine (NVP) or Efavirenz (EFV) + 2 NRTIs)	選鹹餘憲艱鑰觸鑰鏇鬱 = 壓艱夢憲膚築選壓觸簾鹽鑰鏇鹹構蓋鏇遞觸蓋 (構齋廠構夢淵夢艱獵觸, 鏇鑰衊鬱醖鏇淵選築襯 ~ 鏇襯糧壓鹹憲艱蓋憲膚)
NCT00102960 (CHER, CTgov)	临床3期	HIV感染	377	Zidovudine+Abacavir sulfate+Didanosine+Efavirenz+Lamivudine+Nevirapine+Lopinavir/Ritonavir	鹽艱簾鑰憲繭顧衊範壓 = 鏇鹹壓壓憲齋鹽襯鏇鹹鹹壓鑰蓋鑰積遞構構繭 (獵範襯餘艱鑰鑰選衊醖, 衊糧餘廠夢繭淵蓋遞衊 ~ 鹽範廠鬱淵憲簾淵窪選)	-	2018-11-30
NCT00427297 (CTgov)	临床3期	HIV感染	34	d4T/3TC/NVP (stavudine/lamivudine/nevirapine)+Abacavir Sulfate+AZT/3TC/NVP (zidovudine/lamivudine/nevirapine)+Lamivudine+NEVIRAPINE (NVP-containing)	構壓餘糧繭壓鬱糧積積 = 壓鑰鏇廠膚蓋顧鬱膚蓋廠願獵窪衊願廠顧獵簾 (蓋鬱鹽壓膚鑰醖蓋夢獵, 糧構鹹襯積簾蓋觸網願 ~ 鬱鑰憲鏇糧窪廠蓋艱壓) 更多	-	2018-08-27
				stavudine+Tenofovir Alafenamide+Abacavir Sulfate+didanosine+abacavir+Efavirenz+AZT/3TC/ABC (zidovudine/lamivudine/abacavir)+lamivudine+NEVIRAPINE+LOPINAVIR/RITONAVIR (NVP-sparing)	構壓餘糧繭壓鬱糧積積 = 觸襯壓簾壓艱蓋壓網衊廠願獵窪衊願廠顧獵簾 (蓋鬱鹽壓膚鑰醖蓋夢獵, 窪艱觸鏇鹹築獵醖憲艱 ~ 夢膚膚鹹鑰繭夢網壓鑰) 更多
NCT01805258 (Pubmed \| BMC Infect Dis)	临床3期	艾滋病相关机会致病菌感染	284	Nevirapine-based ART	淵積積淵壓衊鏇製積壓(願鹹齋艱構積顧壓範觸) = 壓鬱廠醖鑰簾觸積築鬱餘廠鹽淵遞製夢窪積築 (糧獵憲衊蓋鏇鹽選製醖 ) 更多	积极	2017-12-11
				Efavirenz-based ART	淵積積淵壓衊鏇製積壓(願鹹齋艱構積顧壓範觸) = 鏇憲艱製鑰糧簾齋顧窪餘廠鹽淵遞製夢窪積築 (糧獵憲衊蓋鏇鹽選製醖 ) 更多
NCT00344461 (CTgov)	临床4期	HIV感染	54	Tenofovir+FTC+Nevirapine	獵鹽鑰網廠淵衊蓋壓糧 = 選鏇鬱築醖膚壓鹽簾鏇鏇願蓋繭鑰淵觸繭選遞 (顧糧餘積築壓壓顧鹹鏇, 簾憲遞網廠憲鹽積齋觸 ~ 窪製淵築範顧憲壓艱遞) 更多	-	2017-11-14
NCT00270296 (CTgov)	临床2期	HIV感染	730	Lamivudine/Zidovudine+Lopinavir/Ritonavir	艱鏇餘夢遞網遞顧壓憲 = 觸選窪壓願鬱艱襯選壓餘糧醖膚鹹鹽製製蓋鹽 (鹹鏇窪築選構範鹽衊簾, 觸選顧艱壓製觸襯願膚 ~ 壓膚簾憲窪壓獵艱繭簾) 更多	-	2017-06-05
NCT00307151 (IMPAACT P1060, Pubmed \| Clin Infect Dis)	临床2期	一线	451	Nevirapine-based ART	鏇膚壓鑰鹽憲憲襯淵膚(獵襯鏇積餘遞選窪獵醖): aHR = 1.65 更多	积极	2016-10-15
				Lopinavir/ritonavir-based ART
NCT00409591 (PHPT-5, Pubmed \| AIDS)	临床3期	HIV感染	435	NVP-NVP	構蓋製艱齋膚壓醖齋憲(糧夢觸鏇壓範醖構淵鬱) = 鹹鏇範築築齋願獵網衊遞積淵遞願醖壓鏇簾齋 (鬱衊艱獵構鑰鹽衊膚製, 1.2 ~ 8.6)	-	2015-11-28
				Infant-only NVP	構蓋製艱齋膚壓醖齋憲(糧夢觸鏇壓範醖構淵鬱) = 壓積壓鬱壓廠餘鹽鏇餘遞積淵遞願醖壓鏇簾齋 (鬱衊艱獵構鑰鹽衊膚製, 0.2 ~ 5.6)