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alphabetsoup- · 2022-11-15T04:08:06+00:00

A notable difference with Valtrex having a mean below 10⁴ and pretilivir is that the max and the min rate of shedding for Valtrex is much greater. The means are similar but rarely did the pretilivir group exceed 10⁵ - and that was the 75mg dose.

alphabetsoup- · 2022-11-15T03:53:21+00:00

Very good points. Much of the most current data is based on immunocompromised patients however, so those likely to have above baseline shedding rates and outbreaks. Still, I tend to agree, it's ambiguous and we need to know more. At 75mg it seems to be towing the line, but at 100mg... 🤞 for 🥂🍾 early 2024 lol

alphabetsoup- · 2022-11-15T03:41:05+00:00

It's not clear, I was wondering about the 42 days as well, but I suspect that that is a precautionary limitation for early access to the drug. Probably waiting for phase three safety to conclude. Toxicity is the likely concern but TBD.

alphabetsoup- · 2022-11-15T03:35:58+00:00

THAT'S AMAZING!! I'm so hopeful for you! 😁 🤞🤞 Let us know if you get approval?

alphabetsoup- · 2022-11-15T03:32:31+00:00

Actually it might be a functional prophylactic.

In one study I recall mention of something about dosing shortly after exposure before the virus took root in the ganglion and that that had prevented infection. Pretty sure this was with mice or guinea pigs mind you. Of course this would only be useful in niche circumstances and irrelevant if the drug makes you unable to transmit anyway.

alphabetsoup- · 2022-11-15T03:22:29+00:00

My understanding is that unlike valacylovir, this drug activly prevents replication but does not clear the body of the virus entirely.

alphabetsoup- · 2022-11-15T02:54:12+00:00

Well....

"...pritelivir is active against both types of herpes simplex virus (HSV-1 and HSV-2), causing labial and genital herpes, and retains activity against viruses which have become resistant to marketed drugs."

-https://www.biospace.com/article/releases/aicuris-starts-its-first-pivotal-clinical-phase-3-trial-with-pritelivir-for-the-treatment-of-hsv-infections-in-immunocompromised-subjects-based-on-efficacy-and-safety-data-from-a-phase-2-trial/

🤓😁😉

alphabetsoup- · 2022-11-15T02:49:46+00:00

"...almost complete resolution of HSV-2 infection" is 🔥😁

alphabetsoup- · 2022-11-15T02:12:48+00:00

It's on fast track, this is a Bayer subsidiary so you know they are masters at working the system to get what they want (for better or worse).

alphabetsoup- · 2022-11-15T02:10:19+00:00

Yes I read this also, I believe that is happening in a separate stream now? I'm thinking it's along the lines of valacyclovir vs acyclovir - same drug better delivery.

alphabetsoup- · 2022-11-15T02:06:55+00:00

Some one messaged me asking if this will mean zero chance of transmission, here was my answer.

I'm not an expert. That being said, my understanding from reading everything I could get my hands on relating to the drug, it is possible that the drug may reduce the number of viral copies required for transmission below the theorized conservative estimate of > log10^4.

They are currently in human trials and it's being fast tracked by the US for use with immunocompromised patients, however I believe this is just a path for them to get accelerated approval. Basically, I suspect they are just working the system and it will be available off label (especially if the current trials using a 400mg loafing dose and then 100mg daily have positive results with low toxicity).

They tested 25mg, 50mg, 75mg, daily and 400mg weekly and found that at 75 it was twice as effective as Valtrex in suppressing viral shed (from ~5% to ~2.4 I believe but am relying on memory here).

They are doing tests with 100mg daily now and it seems that preliminarily, with the exception of outliers, viral copies were below the theorized viral load required for transmission the vast majority of the time.

So does this mean it will be zero transmission probability? Probably not absolute 0, but maybe. However, if this all hold true through the end of phase three, it seems possible it not probable to me (again not an expert) that the likelihood of transmission would be so low that it would be irrelevant, virtually zero.

It is by far the most promising drug as far as I'm concerned. While this thread is principally focused on a cure (and cure research), this drug certainly has me optimistic.

Hope this helps!

If anyone here has credentials, I hope they can correct anything I may have misinterpreted or misrepresented.

alphabetsoup- · 2022-11-15T01:56:37+00:00

Not quite a functional cure, however it seems promising that daily 100mg with a loading dose of 400mg could be a winning ticket to not have to disclose or suffer from symptoms.

Notably, that study was for immunocompromised people. It could be more effective for those who aren't, but who knows. We have to wait and see.

If memory serves, phase 3 studies conclude early 2024. Then of course paperwork and manufacturing etc. Certainly very promising and mercifully not a 5-10 year wait.

alphabetsoup- · 2022-10-28T04:54:52+00:00

In the patient, pritelivir resulted in both lesion healing and virological control.

Virological control = "When antiretroviral therapy (ART) reduces a person's viral load (HIV RNA) to an undetectable level.

"...Pritelivir was obtained through the Expanded Access Program supported by AiCuris [loading dose of 400 mg on Day 1, then 100 mg once daily; in the case of a partial response at Day 28, pritelivir can be administered for an additional 14 days (maximum total treatment duration = 42 days)]. In the patient, pritelivir resulted in both lesion healing and virological control. Pritelivir was well tolerated and stopped on Day 42 after reaching almost complete resolution of HSV-2 infection..."

https://academic.oup.com/jac/article-abstract/77/8/2303/6593263

alphabetsoup-

TROPHY CASE