| U.S. 
Food & Drug Administration Approved the use of Reyataz (atazanavir sulfate) 
Boosted with Ritonavir, in Combination Therapy, for Previously Untreated HIV-1 
Infected Adult Patients Based on CASTLE Study Princeton, 
NJ -- October 1, 2008 -- Bristol-Myers Squibb Company announced today that the 
U.S. Food & Drug Administration (FDA) approved the use of Reyataz (atazanavir 
sulfate) 300 mg once-daily boosted with ritonavir 100 mg as part of combination 
therapy in previously untreated (treatment-naive) HIV-1 infected patients. Reyataz 
boosted with ritonavir (Reyataz/r) taken once daily with food is recognized by 
the U.S. Department of Health and Human Services (DHHS) as a preferred component 
of combination HIV therapy for treatment-naive patients(1). For 
treatment-naive patients who are unable to tolerate ritonavir, Reyataz 400 mg 
(without ritonavir), taken once daily with food, is recommended. This 
use of once-daily Reyataz/r in HIV-1 infected treatment-naive adult patients is 
based on 48-week results from the CASTLE study, which demonstrated similar antiviral 
efficacy of Reyataz/r to twice-daily lopinavir/ritonavir (lopinavir/r) [Kaletra], 
each as part of HIV combination therapy, in treatment-naive HIV-1 infected adult 
patients. Within 
the CASTLE study, the Reyataz/r arm was associated with low increases from baseline 
in total cholesterol (13 percent), LDL ["bad"] cholesterol (14 percent), 
HDL ["good"] cholesterol (29 percent), and triglycerides (15 percent). 
The lopinavir/r arm was associated with 25 percent increase in total cholesterol, 
19 percent increase in LDL cholesterol, 37 percent increase in HDL cholesterol, 
and 52 percent increase in triglycerides. Two percent of patients in the Reyataz/r 
arm and eight percent of patients in the lopinavir/r arm required lipid-lowering 
therapy in the study, compared to 1 percent in each arm at baseline. Safety 
events in this study were consistent with prior experience. Grade 2-4 treatment-related 
adverse events that occurred in two percent or greater of patients in the CASTLE 
study included jaundice (4 percent and zero percent), nausea (4 percent and 8 
percent), diarrhea (2 percent and 11 percent) and rash (3 percent and 2 percent) 
in the Reyataz/r and lopinavir/r arms, respectively. Grade 3-4 increases in total 
bilirubin were seen in 34 percent of patients in the Reyataz/r arm and in less 
than 1 percent of patients in the lopinavir/r arm. "Bristol-Myers 
Squibb is committed to developing medicines that enhance the care of people living 
with HIV and AIDS," said Elliott Sigal, MD, PhD, Executive Vice President, 
Chief Scientific Officer and President, Research and Development, Bristol-Myers 
Squibb. "Boosted Reyataz provides health care professionals a newly approved, 
once-daily dosing option as part of combination therapy for patients naive to 
HIV therapy." About 
the CASTLE Study The 
CASTLE study is the first large-scale (n=883), open-label, randomized study designed 
to demonstrate the non-inferiority of Reyataz/r to lopinavir/r in treatment-naive 
HIV-1 infected adult patients. Forty-eight week data from the study were presented 
earlier this year at the 15th Conference on Retroviruses and Opportunistic Infections 
(CROI) in Boston, Mass., and previously announced in a press release on February 
6, 2008. Data from the CASTLE study were also published in the August 23 issue 
of The Lancet. Important 
Information About Reyataz (atazanavir sulfate) 200 mg, 300 mg Capsules Reyataz 
is a prescription medicine used in combination with other medicines to treat people 
who are infected with the human immunodeficiency virus (HIV).  Reyataz 
has been studied in 48-week trials in both patients who have taken or have never 
taken anti-HIV medicines. Reyataz 
does not cure HIV or help prevent passing HIV to others. Reyataz 
should not be taken by patients allergic to Reyataz or to any of its ingredients. Reyataz 
should not be taken with the following medicines: rifampin, Camptosar (irinotecan), 
Versed (midazolam) when taken by mouth, Halcion (triazolam), ergot medicines, 
Propulsid (cisapride), St. John's wort (Hypericum perforatum), Mevacor (lovastatin), 
Zocor (simvastatin), Orap (pimozide), Crixivan (indinavir), or Viramune (nevirapine). Patients 
taking Reyataz should speak with their healthcare provider before taking the following 
medicines: hormonal contraceptives such as birth control pills or contraceptive 
patch, Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil), Vfend (voriconazole), 
AcipHex (rabeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec 
(omeprazole), Protonix (pantoprazole), Axid (nizatidine), Pepcid AC (famotidine), 
Tagamet (cimetidine), or Zantac (ranitidine), Advair (fluticasone propionate and 
salmeterol inhalation powder), Flonase or Flovent (fluticasone propionate), or 
Sustiva (efavirenz). The 
above lists of medicines are not complete. The use of all prescription and non-prescription 
medicines, vitamins, herbal supplements, or other health preparations should be 
discussed with a healthcare provider. Any 
side effects, symptoms, or conditions, including the following, should be reported 
to a healthcare provider right away:  -- 
Mild rash (redness and itching) without other symptoms sometimes occurs in 
patients taking Reyataz, most often in the first few weeks after the medicine 
is started, and usually goes away within two weeks with no change in treatment. 
 -- Severe 
rash has occurred in a small number of patients taking Reyataz. This type 
of rash is associated with other symptoms which could be serious and potentially 
cause death. If rash develops with any of the following symptoms, the patient 
should stop using Reyataz and call a healthcare provider right away:   
 
       
Shortness of breath  
       
General ill-feeling or "flu-like" symptoms
  
       
Fever
  
       
Muscle or joint aches
  
       
Conjunctivitis (red or inflamed eyes, like "pink-eye")
  
       
Blisters
  
       
Mouth sores
  
       
Swelling of the face
 -- 
Yellowing of the skin and/or eyes may occur due to increases in bilirubin 
levels in the blood (bilirubin is made by the liver).  -- 
A change in the way the heart beats may occur and could be a symptom of a 
heart problem. 
 -- Diabetes and high blood sugar may occur in patients 
taking protease inhibitor medicines like Reyataz.
 
 -- In patients with 
liver disease, including hepatitis B or C, the liver disease may get worse 
when taking anti-HIV medicines like Reyataz.
 
 -- Kidney stones have 
been reported in patients taking Reyataz. Signs or symptoms of kidney stones include 
pain in the side, blood in the urine, and pain when urinating.
 
 -- End 
stage kidney disease managed with hemodialysis.
 -- 
Some patients with hemophilia have increased bleeding problems with protease 
inhibitor medicines like Reyataz.
 
 -- Changes in body fat have been 
seen in some patients taking anti-HIV medicines. The cause and long-term effects 
are not known at this time.
 
 Other side effects of Reyataz taken with other 
anti-HIV medicines include: nausea, headache, stomach pain, vomiting, diarrhea, 
depression, fever, dizziness, trouble sleeping, numbness, and tingling or burning 
of hands or feet.
 Reyataz 
should be taken once daily with food (a meal or snack). Reyataz and other anti-HIV 
medicines should be taken exactly as instructed by healthcare providers. Please 
see accompanying Full Prescribing Information, or visit www.reyataz.com 
or www.BMS.com. About 
Bristol-Myers Squibb Bristol-Myers 
Squibb is a global biopharmaceutical company whose mission is to extend and enhance 
human life. For more information visit www.bms.com. (1) 
Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for 
the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department 
of Health and Human Services. January 29, 2008; 1-128. Available at http://aidsinfo.nih.gov. 
Accessed September 25, 2008.  |