Gilead’s Quad Pill Raises Kidney Questions, FDA Says

Gilead Sciences Inc.’s experimental HIV pill Quad may need additional monitoring because of kidney damage seen in studies, U.S. regulators said.

The four-in-one combination pill from Gilead, the largest maker of AIDS drugs, had a “generally acceptable” safety profile and retained more patients than standard treatments, Food and Drug Administration staff said in a report today. The agency asked advisers whether patients taking the drug should undergo extra testing to monitor for kidney complications.

The medicine is designed to have fewer side effects than current treatments. Approval of the Quad pill is crucial for Foster City, California-based Gilead, said Robyn Karnauskas, an analyst with Deutsche Bank AG in New York. The drugmaker is facing the loss of half of its revenue from patent expirations on AIDS therapies starting in 2018. If approved the new medicine may generate as much as $4 billion in annual sales, she said.

“It is really important for Gilead as a stock that the Quad comes to market and there is nothing bad in the data,” Karnauskas said in a telephone interview. “It will really hurt the stock if this drug doesn’t come to market.”

The FDA’s panel of advisers will meet on May 11 to make a recommendation on the drug. The agency doesn’t have to follow the advice of the committee.

Shares Gain

Gilead rose 2.4 percent to $50.64 at the close of New York trading. The stock has gained 23 percent in the past 12 months.

Gilead’s three-drug pill Atripla, approved in 2006, is the top-selling AIDS medicine. The therapy mixes Gilead’s two-drug medicine Truvada, approved in 2004, with Bristol-Myers Squibb Co.’s Sustiva. Quad contains four Gilead compounds in a single pill that patients take once a day.

An FDA review of studies funded by Gilead found a higher number of kidney problems reported in people taking Quad compared with other HIV treatments. Those side effects included four cases of kidney failure and one case of a rare syndrome where substances aren’t absorbed into the blood stream by the kidneys.

Still, there were fewer patients who stopped taking Quad early because of side effects and the incidence of side effects was similar to other drugs, the FDA said.

Karnauskas said she isn’t concerned that the kidney risk may prevent the drug from getting to market.

“It is just a minor detail, which is why I’m not worried,” she said.

Company-sponsored studies have shown Quad works as well as Atripla. Eighty-eight percent of patients in a 48-week study who took Quad had no detectable levels of HIV in their blood compared with 84 percent of those taking Atripla, according to research presented in March at the Conference on Retroviruses and Opportunistic Infections in Seattle.

The FDA is scheduled to decide by Aug. 27 whether to approve Quad for U.S. sale.

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