Fostemsavir, a Drug with Novel Mechanism for the Treatment of HIV-1 Infection

HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.