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After the explosion of drug development that yielded the approval of four antiretrovirals in just 16 months (darunavir, raltegravir, maraviroc, and etravirine), only a few promising drug candidates are in an advanced stage of clinical development — the nonnucleoside reverse transcriptase inhibitor rilpivirine and two integrase inhibitors, elvitegravir and S/GSK1349572 (or 572). All are intended as once-daily options, primarily for patients who have never taken antiretroviral therapy.
Rilpivirine emerged as a potential front-runner nearly 4 years ago, but the data presented this summer were decidedly mixed. The drug was found to be better tolerated than efavirenz but did not appear to be quite as active virologically, especially in patients w…