The making of the one pill-Developing single tablet regimens for HIV and for HCV

Antivir Ther. 2022 Apr;27(2):13596535211067606. doi: 10.1177/13596535211067606.

Abstract

A concept of "all or nothing" inspired the innovation of a one-pill-once-daily HIV treatment. Atripla® was the one pill that combined efavirenz, emtricitabine, and tenofovir disoproxil fumarate to become the first daily single tablet regimen that forever simplified HIV treatment to enhance patient compliance and thus, sustained viral suppression. The making of Atripla incorporated dry granulation and bilayer compression technologies to achieve stability and bioequivalence in an optimal pill size. In 2011, there lacked a standard of care for chronic hepatitis C infections that was safe, simple, short, free of interferon and ribavirin, and with high cure rates. A fixed-dose combination of ledipasvir and sofosbuvir was developed and approved in 2014 to be the first complete daily single tablet regimen for CHC genotype 1 infection. A spray-drying process for particle morphology engineering in a polymer matrix was used for improving bioavailability.

MeSH terms

  • Adenine / therapeutic use
  • Anti-HIV Agents* / therapeutic use
  • Deoxycytidine / therapeutic use
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / therapeutic use
  • HIV Infections* / drug therapy
  • Hepatitis C* / drug therapy
  • Humans
  • Organophosphonates* / therapeutic use
  • Tablets / therapeutic use

Substances

  • Anti-HIV Agents
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Organophosphonates
  • Tablets
  • Deoxycytidine
  • Adenine