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14-September-2008 18:02:40 - Integrase inhibitor Integrase inhibitors are a class of antiretroviral drug designed to block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. Since integration is a vital step in retroviral replication, blocking it can halt further spread of the virus. Integrase inhibitors were initially developed for the treatment of HIV infection, but they could be applied to other retroviruses. The first integrase inhibitor approved by the US Food and Drug Administration FDA was Raltegravir brand name Isentress, approved on October 12, 2007. Research results published in the New England Journal of Medicine on July 24, 2008, concluded that raltegravir plus optimized background therapy provided better viral suppression than optimized background therapy alone for at least 48 weeks. 1 Since integrase inhibitors target a distinct step in the retroviral life cycle, they may be taken in combination with other types of HIV drugs to minimize adaptation by the virus. They are also useful in salvage therapy for patients whose virus has mutated and acquired resistance to other drugs. Drugs under development Elvitegravir GS 9137 or JTK-303, licensed by Gilead Sciences from Japan Tobacco, is currently undergoing Phase 2 clinical trials. GS 9137 is a low-molecular-weight, highly selective integrase inhibitor that shares the core structure of quinolone antibiotics.2 References ^ http://content.nejm.org/cgi/content/abstract/359/4/339 Steigbigel, et al, Raltegravir with Optimized Background Therapy for Resistant HIV-1 Infection, NEJM 359:339-354 ^ AIDSinfo - HIV/AIDS Drug Information - GS 9137 elvitegravir External links MK-0518, the first Integrase Inhibitor for HIV HIV Antiretroviral Agents in Development GS 9137 elvitegravir factsheet from NIH Savarino A. A historical sketch of the discovery and development of HIV-1 integrase inhibitors. Expert Opin Investig Drugs. 2006 Dec;1512:1507-22. 12 MeSH integrase+inhibitors v d e Pharmacology: enzyme inhibition Class Competitive inhibition - Uncompetitive inhibition - Non-competitive inhibition - Suicide inhibition - Mixed inhibition Substrate Oxidoreductase EC 1: Aromatase inhibitors - Lipoxygenase inhibitor - Monoamine oxidase inhibitors - COX-2 inhibitor Transferase EC 2: Integrase inhibitor - Protein kinase inhibitors - Reverse transcriptase inhibitors - COMT inhibitors Hydrolase EC 3: Acetylcholinesterase inhibitors - Phosphodiesterase inhibitors - Protease inhibitors ACE inhibitor, Trypsin inhibitor - Histone deacetylase inhibitor Lyase EC 4: Carbonic anhydrase inhibitors v d e Antivirals used against HIV HAART primarily J05 Nucleoside Nucleotide Reverse Transcriptase Inhibitors NRTI Abacavir ABC° Dexelvucitabine§ Emtricitabine° Lamivudine 3TC° Tenofovir° Didanosine Zidovudine AZT Apricitabine† Stampidine† Elvucitabine† Racivir† Amdoxovir† Stavudine‡ Zalcitabine‡ Non-Nucleoside Reverse Transcriptase Inhibitors NNRTI Ateviridine§ Capravirine§ Efavirenz° Emivirine§ Lodenosine§ Nevirapine Etravirine Rilpivirine† Loviride‡ Delavirdine‡ Quinotaline§ Protease Inhibitors PI Atazanavir° Brecanavir§ Fosamprenavir° Lopinavir° Darunavir Nelfinavir Ritonavir Saquinavir Tipranavir Amprenavir‡ Indinavir‡ Entry/fusion inhibitors Aplaviroc§ Enfuvirtide Maraviroc Vicriviroc† PRO 140† Ibalizumab† Integrase inhibitors Raltegravir Elvitegravir† Maturation inhibitors Bevirimat† Vivecon† Combined formulations Combivir Atripla Trizivir Truvada Kaletra Epzicom Other experimental agents Foscarnet Hydroxyurea Synergistic enhancers Epigallocatechin gallate Portmanteau inhibitors Globoidnan A Griffithsin Diarylpyrimidines Calanolide A Cyanovirin-N Miltefosine R-roscovitine† °DHHS preferred first-line agent. †Undergoing clinical trials, not FDA approved. ‡Formerly or rarely used agent. §Development terminated. Pills This antimicrobial-related article is a stub. Retrieved from http://en..org/wiki/Integrase_inhibitor Categories: Antiretroviral drugs | Inhibitors | Antimicrobial stubs Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Français This page was last modified on 22 August 2008, at 17:50
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