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Comparative Study | Journal Article

Antiviral and resistance studies of AG1343, an orally bioavailable inhibitor of human immunodeficiency virus protease.

A K Patick, H Mo, M Markowitz, K Appelt, B Wu, L Musick, V Kalish, S Kaldor, S Reich, D Ho, S Webber
A K Patick
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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H Mo
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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M Markowitz
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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K Appelt
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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B Wu
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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L Musick
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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V Kalish
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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S Kaldor
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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S Reich
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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D Ho
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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S Webber
Department of Pharmacology, Agouron Pharmaceuticals, Inc., San Diego, CA 92121, USA.
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DOI: 10.1128/AAC.40.2.292
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ABSTRACT

AG1343 ([3S-(3R*,4aR*,8aR*,2'S*,3'S*)]-2-[2' hydroxy-3'-phenylthiomethyl-4'-aza-5'-oxo-5'-(2''-methyl-3''-hydro xy-phenyl) pentyl]-decahydroiso-quinoline-3-N-t-butylcarboxamide methanesulfonic acid) is a selective, nonpeptidic inhibitor of human immunodeficiency virus (HIV) protease (Ki = 2 nM) that was discovered by protein structure-based drug design methodologies. AG1343 was effective against the replication of several laboratory and clinical HIV type 1 (HIV-1) or HIV-2 isolates including pyridinone- and zidovudine-resistant strains, with 50% effective concentrations ranging from 9 to 60 nM. In reversibility studies, inhibition of gag (p55) proteolytic processing in HIV-1 particles from cells treated with AG1343 was maintained for up to 36 h after drug removal. The ability of virus to develop resistance to AG1343 was studied by serial passage of HIV-1 NL4.3 in the presence of increasing concentrations of drug. After 28 passages, a variant with a 30-fold reduction in susceptibility to AG1343 was isolated. Molecular analysis of the protease from this variant indicated a double change from a Met to Ile at residue 46 and an Ile to Val or Ala at residue 84 (M46I+I84V, A). Consistent with these findings, reductions in susceptibility were observed for recombinant viruses constructed to contain the single I84V change or the double M46I+I84V substitutions. Resistance, however, was not detected for recombinant viruses containing other key mutations in HIV-1 protease, including a Val to Ile change at residue 32 or a Val to Ala or Phe at residue 82. The potent anti-HIV activity of AG1343 against several isolates suggests that AG1343 should perform well during ongoing human phase II clinical trials.

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Antiviral and resistance studies of AG1343, an orally bioavailable inhibitor of human immunodeficiency virus protease.
A K Patick, H Mo, M Markowitz, K Appelt, B Wu, L Musick, V Kalish, S Kaldor, S Reich, D Ho, S Webber
Antimicrobial Agents and Chemotherapy Feb 1996, 40 (2) 292-297; DOI: 10.1128/AAC.40.2.292

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Antiviral and resistance studies of AG1343, an orally bioavailable inhibitor of human immunodeficiency virus protease.
A K Patick, H Mo, M Markowitz, K Appelt, B Wu, L Musick, V Kalish, S Kaldor, S Reich, D Ho, S Webber
Antimicrobial Agents and Chemotherapy Feb 1996, 40 (2) 292-297; DOI: 10.1128/AAC.40.2.292
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