Mail & Guardian (Johannesburg) - February 17, 1995
Anouk Mommer and Inge Ruigrok

A PRETORIA pharmaceutical company claims to have developed a drug that will improve the length and quality of the lives of Aids sufferers.

Dr Roy van Brummelen, a director of Biomox, said this week clinical tests indicated the new product, Equimmune, could be the most successful drug in Aids treatment since AZT.

But local Aids experts have expressed caution, warning that the benefit of drugs similar to Equimmune have turned out to be illusory.

Van Brummelen claims Equimmune increases the CD4 count, the key indicator of the body's ability to produce antibodies, by an average 15 percent, and stabilises it at this point.

In contrast, the Aids drug AZT strengthens the immune system for 10 to 15 weeks, and then the benefit tapers off.

Drugs like AZT, TDC, TDI and D4T try to slow down the replication of the Aids virus, so that the immune system will also be affected positively, while Equimmune is focused only on the strengthening and stabilisation of the immune system.

Biomox tested the drug for a year on 30 Johannesburg patients. Then the company redid the test over six months on another set of people in Johannesburg and Cape Town.

"Ninety percent actually developed a stronger immune system," said Van Brummelen. "Today the CD4 count of patients who were treated with Equimmune two years ago is still at the same level.

"At this stage it's too early to say whether it can lead to a medicine which cures Aids, but we are excited. Our approach is quite unique, certainly in South Africa."

Not everyone shares his optimism. Dr Clive Evian, co- ordinator of the Alexander Forbes Aids Consulting and Support Unit, said the new drug sounds encouraging, but nothing much can be expected at this stage. "Drugs similar to Equimmune have been developed in the past, but they haven't led to anything essential."

This, said his colleague Dr Gillian Gresak, is because every patient reacts differently to the drugs. "They can even become sicker. That is why a lot of patients quit the formal medication and try psychoneuro immunology." Instead of working on the body, this treatment focuses on the mind, teaching Aids patients to be less vulnerable to opportunistic infection.

Biomox is negotiating with insurance companies to have the drug covered and has already applied for registration with the Medicines Control Council, which evaluates the trials and results of the developers' tests in terms of safety, efficacy and quality.

Van Brummelen expects Equimmune -- which he said will be less expensive than AZT -- to be on the market within two months.

Evian is not so sure. He said Biomox needs to do more research, more trials before Equimmune can be considered a breakthrough -- including independent assessment, tests in collaboration with clinics throughout the country and double-blind trials (where one set of patients is given the drug and another set a placebo).

Biomox has done only clinical tests on 133 patients. The health of those patients it has been tested on appears to have improved. But, he said, Biomox hasn't tested Equimmune long enough to see whether the drug will also encourage "clinical and survival benefits. Only when further inquiry on Equimmune shows proper results can we go and have a drink."

A well-known HIV researcher, who wants to remain anonymous, agrees with Evian.

"The news about Equimmune is exaggerated. Biomox has only results of short-term inquiries. It appears to be a well-working medicine, certainly in combination with other Aids drugs.

But we need to be rational and considerate. Long-term studies have to be done."

The news should not have been released yet, said the researcher, "especially considering the hopes of patients with Aids".

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