UB pharmacologists launch Web site to help practitioners evaluate AIDS drugs

Pharmacologists in the School of Pharmacy have launched a Web site where practitioners will be able to share and evaluate information about how anti-HIV medications work and interact.

Practitioners will be able to use the network to post questions and report on individual cases, providing a much-needed nationwide network on post-approval surveillance of AIDS drugs. Since most anti-HIV medications undergo accelerated approval by the Food and Drug Administration, there usually is very little published data on how they work and interact at the time they are released. That information often isn't available for months or years.

"With accelerated approval, you get only a very small snapshot of these drugs, such as their efficacy and major adverse effects," said Gene D. Morse, professor and chair of the Department of Pharmacy Practice in the School of Pharmacy and head of the editorial board that is supervising the site.

The National HIV Pharmacotherapy Network, which can be accessed at <http://wings.buffalo.edu/hiv_pharm_net>, will provide an organized mechanism for storing, sharing, evaluating and publicizing critical information on dosing, drug combinations, access to clinical trials, herbal and homeopathic remedies, late-breaking news and related items.

Some areas of the site will be accessible to patients and members of the general public.

The site is accepting registrations; postings will begin early in 1999. Approximately 5,000 pharmacists in the U.S. work with HIV patients and a majority are expected to participate eventually, in addition to health-care providers from around the globe.

"There are now 13 AIDS drugs on the market and as more drugs become available, the need for more information on them has grown dramatically," said Morse, who also is vice chair of the Pharmacology Committee of the National Institutes of Health-sponsored AIDS Clinical Trials Group, and who serves as pharmacologist for many ACTG clinical studies.

Based in the UB Department of Pharmacy Practice, the network will benefit from Morse's experience with the NIH group and with the Antiviral Clinical Pharmacology Laboratory Unit that he directs in the Erie County Medical Center in collaboration with Ross Hewitt, UB associate professor of clinical medicine and medical director of the hospital's Immunodeficiency Services program.

Morse noted that drug combinations have become the standard in treating HIV patients as a way to lessen the chances that the virus will develop resistance.

"But when you combine three or four or five of these new drugs together, what does that translate into in terms of toxicity?" he asked.

The National HIV Pharmacotherapy Network provides a way to deal with this issue by establishing a secure site for a moderated discussion among practitioners who are on the front lines, dealing with patients.

Much of the information submitted to the network also will be made available in a database of selected topics that will be part of the site.

"There is all this information out there, about combinations that do work well for patients, but until now, there has been no way to collect information on overall use patterns," said Morse.

In addition, he said that the speed with which things change in the AIDS community made a Web site practically a necessity.

For example, his lab, among others, is conducting pharmacologic research on several non-nucleoside reverse transcriptase inhibitors, AIDS drugs that, until very recently, looked as though they would be eclipsed by the extremely promising protease inhibitors.

But major side effects caused by the protease inhibitors were the hot topic at this summer's AIDS meeting in Geneva.

"Now these drugs have suddenly become an alternative to protease inhibitors," said Morse, "and the question becomes, 'Should you prescribe drug regimens without protease inhibitors?'"

Designed to become the key information source on AIDS drugs for pharmacists in hospitals, clinics and the community, as well as for health-care providers, the network also will be available to subscribers without computer access through a quarterly publication.

The National HIV Pharmacotherapy Network was developed with initial support from Agouron Pharmaceuticals, Inc. and the UB School of Pharmacy. Sustaining funds will be sought from health-care foundations and the pharmaceutical industry.