
Adefovir dipivoxil
'Adefovir dipivoxil', previously called 'bis-POM PMEA', with trade names 'Preveon®' and 'Hepsera®', is an orally-administered nucleotide analog
reverse transcriptase inhibitor (ntRTI) used for treatment of
hepatitis B. It is a failed treatment for
HIV.
History
Adefovir was invented in the Institute of Organic Chemistry and Biochemistry,
Academy of Sciences of the Czech Republic by
Antonín Holý, and the drug was developed by
Gilead Sciences for
HIV with the brand name 'Preveon'. However, in November 1999, an expert panel advised the U.S.
Food and Drug Administration (FDA) not to approve the drug due to concerns about the severity and frequency of kidney toxicity when dosed at 60 or 120 mg. The FDA followed that advice, refusing to approve adefovir as a treatment for HIV.
Gilead Sciences discontinued its development for HIV treatment in December 1999 but continued to develop the drug for
hepatitis B (HBV), where it is effective with a much lower dose of 10 mg. FDA approval for use in the treatment of hepatitis B was granted on
September 20,
2002, and adefovir is sold for this indication under the brand name ''Hepsera''.
Adefovir became an approved treatment for HBV in the United States in September 2002 and in the European Union in March 2003.
Mechanism of action
Adefovir works by blocking
reverse transcriptase, an enzyme that is crucial for the
hepatitis B virus (HBV) to reproduce in the body.
It is approved for the treatment of chronic hepatitis B in adults with evidence of active viral replication and either evidence of persistent elevations in serum
aminotransferases (primarily ALT) or histologically active disease.
The main benefit of adefovir over
lamivudine (the first NRTI approved for the treatment of hepatitis B) is that it takes a much longer period of time before the virus develops resistance to it.
External links
★
Hepsera web site
★ - Adefovir dipivoxil