New research shows that the once-daily combination therapy Stribild, also known as the “Quad” because it contains four antiretrovirals (ARVs), is as effective as both Atripla and a Reyataz plus Truvada combination. Researchers recruited 1,408 people with HIV and randomly assigned 701 to receive Stribild, 352 to take Atripla and 355 to take Reyataz plus Truvada.

After 96 weeks of treatment, 84 percent of those on Stribild had an undetectable viral load, compared with 82 percent in both of the other groups. CD4 gains were also similar between the three treatment arms, ranging between 261 and 275 new cells.

Meanwhile, Stribild showed promise in the psychiatric side effects category. Fourteen percent of those taking Atripla reported abnormal dreams, while just 4 percent of those taking Stribild and 1 percent of those on Reyataz plus Truvada did so. Four percent of the Atripla arm reported dizziness, compared with only I percent in the other two groups.

Tony Mills, MD, an HIV doctor in Los Angeles who says he's “so much more likely” to prescribe Stribild than Atripla, anticipates the older drug will see its blockbuster status fade away. In a recent discussion with top HIV physicians from across the country, he reports: “Everybody across the board said they couldn't remember the last time they'd written a [new] prescription for Atripla.”