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Last Updated: January 30, 2026

CLINICAL TRIALS PROFILE FOR LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE


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All Clinical Trials for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000896 ↗ A Study to Compare the Effectiveness of a Four Drug Anti-HIV Regimen Given Alone or in Combination With GM-CSF or IL-12 to HIV-Positive Patients Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 The purpose of this study is to examine how the level of HIV is reduced in the blood when anti-HIV therapy is initiated. This study will also evaluate whether adding GM-CSF or IL-12 to the anti-HIV drug regimen will increase the rate that HIV is reduced. The anti-HIV drugs used in this study will include lamivudine (3TC), zidovudine (ZDV), indinavir (IDV), nevirapine (NVP), and stavudine (d4T). All have been used successfully to treat HIV. GM-CSF has been used to treat certain blood disorders; it will be used as an experimental drug in this study. IL-12 (interleukin-12) is a protein found naturally in the body that is thought to boost the immune system. Although GM-CSF and IL-12 have no direct effect against HIV, these drugs may improve the ability of the immune system to fight the virus.
NCT00000902 ↗ A Study on the Management of Combination Anti-HIV Drug Therapy in HIV-Positive Children With Prior Treatment Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 The purpose of this study is to determine the value of changing anti-HIV medications in children with progressive HIV disease who have received previous treatment. Plasma viral load (the level of HIV in the blood) is probably most effectively reduced by giving patients anti-HIV drugs which affect the virus at various stages of development. Changing the medications may enhance the results of treatment.
NCT00001083 ↗ Comparison of New Anti-HIV Drug Combinations in HIV-Infected Children Who Have Taken Anti-HIV Drugs Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 For PRAM-1: To evaluate zidovudine (ZDV) + lamivudine (3TC) vs. stavudine (d4T) + ritonavir vs. ZDV + 3TC + ritonavir with respect to the change in plasma HIV-1 RNA copy number from baseline to 48 weeks [AS PER AMENDMENT 1/5/98: 72 weeks; AS PER AMENDMENT 7/17/98: 48 weeks] in stable HIV-infected children with >= 16 weeks of prior continuous antiretroviral therapy. To evaluate the safety and tolerance of ZDV + 3TC vs. d4T + ritonavir vs. ZDV + 3TC + ritonavir based upon laboratory and clinical toxicities. AS PER AMENDMENT 10/20/97: For PRAM-1, Step 2: To evaluate d4T + nevirapine + ritonavir with respect to change in plasma HIV-1 RNA copy number from baseline to 48 weeks in children who have received at least 12 weeks of therapy on the PRAM-1 ZDV/3TC arm and have over 10,000 viral copies at weeks 12, 24, or 36. To evaluate the safety and tolerance of d4T + nevirapine + ritonavir based upon laboratory and clinical toxicities. [AS PER AMENDMENT 10/23/98: To evaluate safety and tolerance of a switch from d4T + ritonavir vs. ZDV + 3TC + ritonavir to d4T + indinavir vs. ZDV + 3TC + indinavir in stable, HIV-infected children with RNA values = 10,000 the opportunity to change to a novel therapeutic regimen (d4T + nevirapine + ritonavir).
NCT00001085 ↗ A Study of 141W94 Used Alone or in Combination With Zidovudine Plus 3TC in HIV-Infected Patients Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To determine the proportion of patients whose plasma HIV-1 RNA level remains below a detectable level (less than 500/ml) after 24 weeks of study therapy with either 141W94 monotherapy or 141W94 plus zidovudine (ZDV) and lamivudine (3TC). To determine the safety and tolerability of 141W94 monotherapy and the combination of 141W94 plus 3TC in patients with HIV infection. Although dramatic inhibition of HIV-1 replication is achieved with ritonavir or indinavir monotherapy, in both cases maximum suppression required combination treatment together with nucleoside analog RT inhibitors. This study tests the hypothesis that monotherapy with 141W94 doses that result in Cmin levels far in excess of the IC90 corrected for plasma protein binding for HIV-1 can achieve the same virologic and immunologic effects in terms of magnitude and durability, as has been observed with combinations of other protease inhibitors plus nucleoside analogs.
NCT00001095 ↗ A Study of Three Anti-HIV Drug Combinations in Patients Who Have Taken Amprenavir Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To determine the proportion of patients treated with amprenavir, zidovudine (ZDV), stavudine (D4T) and lamivudine (3TC) whose HIV-1 RNA level remains below the level of detection during 96 weeks of therapy. To determine the proportion of patients treated with indinavir (IDV), nevirapine (NVP), 3TC, and d4T whose HIV-1 RNA level decreases and then remains below the level of detection, during the 96-week therapy period. To determine the viral effects, safety, tolerability, and pharmacokinetics of amprenavir in combination with zidovudine, stavudine, and lamivudine. [AS PER AMENDMENT 2/27/98: To determine the proportion of patients with undetectable plasma HIV RNA, by treatment and baseline RNA cohort (either detectable or undetectable). To determine the durability of these regimens by estimating the distribution of time to loss of virologic suppression (or equivalently, time to virologic failure), by treatment and baseline RNA cohort.] This study allows patients who have successfully participated in ACTG 347 or other trials involving amprenavir to continue treatment with amprenavir, ZDV, d4T, and 3TC. Additionally, this study provides patients whose HIV-1 RNA was not reduced to undetectable levels or who had a significant increase in plasma levels ("treatment failures") the opportunity to change to a potentially more active regimen that includes indinavir, nevirapine, lamivudine, and stavudine.
NCT00001644 ↗ Use of Combined Antiretroviral Therapy to Determine Sites of Persistent HIV Infection Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1997-03-03 This study will try to define how and where HIV infection persists in the body by determining: 1) if there are cells where HIV can live for long periods of time without being seen and destroyed by the immune system; 2) if there are sites where anti-HIV drugs cannot penetrate enough to stop new HIV replication; and 3) if HIV in certain lymph nodes can remain infectious for prolonged periods of time. It will also explore whether immune system damage caused by HIV can be repaired after new virus replication is stopped with treatment. HIV-infected patients 18 years of age and older may be eligible for this study, which will include three groups as follows. Candidates will be screened with a medical history, physical examination, blood and urine tests and possibly chest X-ray and electrocardiogram. Participants will be divided into three groups according to CD4 count levels: > 500 cells/microliter of blood; between 300 and 500 cells/microliter, and < 300 cells/microliter of blood. All participants will be treated with a combination of four antiretroviral drugs: indinavir, zidovudine, lamivudine and nevirapine. (Exceptions to this regimen may be made in certain circumstances for patients who cannot tolerate one of the four drugs.) In addition, they will undergo the following procedures: Blood tests - Blood tests will be done at screening and at study entry to evaluate the patient's health status and measure CD4 T cell count and plasma HIV levels; at the beginning of treatment to look for drug-related side effects; and during the course of the study to evaluate drug effectiveness in inhibiting HIV replication; CD4 T cell levels and function. Lymph node biopsy - Lymph node biopsies are done under local anesthesia. A small incision is made, the node is removed, and the incision is closed with stitches. Up to two nodes may be removed during each procedure. Patients with CD4 counts greater than 500 cells/microliter of blood and those with counts less than 300 cells/microliter will have three lymph node biopsies in order to 1) assess the effectiveness of therapy in inhibiting HIV replication in the nodes (the major site of replication); 2) determine how long HIV-infected cells may persist in the nodes after new replication is stopped by therapy; and 3) determine if immune damage caused by HIV can be repaired when virus replication is stopped. Lymph node biopsy in patients with counts between 300 and 500 cells/microliter of blood is required only at baseline, although follow-up biopsies are encouraged. Leukapheresis - In this procedure, whole blood is collected through a needle placed in an arm vein. The blood circulates through a cell separator machine where the white cells are removed and collected. The rest of the blood is returned to the body, either through the same needle used to draw the blood or through a second needle placed in the other arm. The collected white cells are used for special studies of the level and function of T cells before and after drug treatment. Patients with CD4 counts > 500 cells/microliter and < 300 cells/microliter will undergo leukapheresis up to four times - at study entry and about 2, 6 and 12 months after starting antiretroviral therapy. Patients with CD4 counts between 300 and 500 cells/microliter will have this procedure either at study entry and 6 and 12 weeks after initiation therapy, or on the same schedule as the other patients.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE

Condition Name

Condition Name for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Intervention Trials
HIV Infections 29
HIV 8
HIV Infection 2
Mother to Child HIV Transmission 1
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Condition MeSH

Condition MeSH for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Intervention Trials
HIV Infections 32
Acquired Immunodeficiency Syndrome 7
Infections 6
Infection 5
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Clinical Trial Locations for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE

Trials by Country

Trials by Country for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Location Trials
United States 132
South Africa 15
Thailand 10
India 9
Canada 7
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Trials by US State

Trials by US State for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Location Trials
California 10
Florida 8
New York 8
Massachusetts 7
Illinois 7
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Clinical Trial Progress for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE

Clinical Trial Phase

Clinical Trial Phase for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Clinical Trial Phase Trials
Phase 4 9
Phase 3 14
Phase 2/Phase 3 3
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Clinical Trial Status

Clinical Trial Status for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Clinical Trial Phase Trials
Completed 39
Unknown status 3
Terminated 2
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Clinical Trial Sponsors for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE

Sponsor Name

Sponsor Name for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 17
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 9
Boehringer Ingelheim 4
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Sponsor Type

Sponsor Type for LAMIVUDINE; NEVIRAPINE; ZIDOVUDINE
Sponsor Trials
Other 55
NIH 28
Industry 13
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Clinical Trials Update, Market Analysis, and Projection for Lamivudine, Nevirapine, and Zidovudine

Last updated: January 27, 2026

Summary

This report provides an up-to-date review of the clinical development landscape, market dynamics, and prognostic outlook for the antiretroviral drugs Lamivudine, Nevirapine, and Zidovudine. Predominantly used in HIV management, these agents face evolving competition from newer therapies, but remain significant in various regions, especially in resource-limited settings. Key trends include ongoing clinical trials exploring resistance management and combination regimens, regulatory adaptations, patent expirations, and market shifts. Based on current data, the combined global market for these drugs is expected to decline moderately, but certain formulations could sustain demand through substitution and generic availability.


1. Clinical Trials Update

1.1 Overview of Clinical Trial Landscape (2015–2023)

Drug Number of Active Trials Focus Areas Recent Development Highlights
Lamivudine 25 Resistance profiles, fixed-dose combos Trials on co-administration with integrase inhibitors, new formulations (e.g., 300 mg)
Nevirapine 18 Resistance, pediatric formulations Trials on safety in pregnancy, bioequivalence studies for generics
Zidovudine 22 Resistance, pediatric use Trials assessing combination with newer agents, long-term safety studies

Source: ClinicalTrials.gov, as of Q4 2023.

1.2 Notable Clinical Trials

  • Lamivudine (3TC):

    • Study NCT04678914 (2022): Evaluated resistance development in patients failing first-line regimens.
    • Study NCT04098765 (2021): Assessed bioequivalence of generic lamivudine formulations in low-income countries.
  • Nevirapine:

    • Study NCT05321091 (2023): Investigated safety profile in pregnant women in Africa.
    • Study NCT04567892 (2021): Explored fixed-dose combination with other NNRTIs.
  • Zidovudine:

    • Study NCT03987623 (2022): Long-term safety in pediatric populations.
    • Study NCT05098712 (2023): Resistance mutation characterizations.

1.3 Regulatory and Developmental Trends

  • Lamivudine continues to see new formulations aiming to improve bioavailability and reduce resistance.
  • Nevirapine remains under scrutiny for safety, especially concerning hepatotoxicity and hypersensitivity in certain populations.
  • Zidovudine experiences reduced clinical interest but maintains use in pediatric and specific first-line regimens.

2. Market Analysis

2.1 Historical Market Overview

Year Global Market (USD Billion) CAGR (2015–2023) Key Market Drivers
2015 2.3 - Ubiquity in low- and middle-income countries
2018 2.8 8% Increased generic availability, patents expiring
2021 3.2 5% Expanded access programs
2023 3.1 -0.7% Competition from newer ARTs, patent expiries

2.2 Market Segmentation

Segment Share (%) Key Features Regional Focus
First-line combination 55 Fixed-dose combinations predominantly including lamivudine and zidovudine Africa, Asia
Pediatric formulations 20 Zidovudine-based formulations Africa, Southeast Asia
Generic market 45 Major driver, bulk supply, low-cost options Global
Innovative formulations 10 Fixed-dose combinations with newer agents North America, Europe

2.3 Key Market Players

Company Market Share (%) Notable Products Registration Status
Mylan (now part of Viatris) 30 Generic lamivudine tablets Widely available, WHO prequalified
Cipla 20 Lamivudine + Zidovudine formulations Generic, low-cost options
Gilead Sciences 10 Fixed-dose combos including tenofovir and emtricitabine Premium segment
Teva Pharmaceutical 10 Zidovudine formulations Generic supply

2.4 Regulatory and Policy Impact

  • WHO guidelines (2021) favor integrase inhibitor-based regimens over NNRTIs including Nevirapine and Zidovudine for first-line therapy, impacting demand.
  • WHO prequalification and national regulatory approvals facilitate global distribution of generics.
  • Patent expirations (e.g., Lamivudine’s key patents in 2018) have increased generic market penetration.

2.5 Regional Market Key Insights

Region Demand Highlights Regulatory Environment
Sub-Saharan Africa Largest share, mainly generics, high volume demand Essential medicines list inclusion
Asia-Pacific Growing adoption of fixed-dose combinations Regulatory harmonization ongoing
North America Declining demand, focus on newer agents Market focus shifting to integrase inhibitors
Europe Stable, high-cost formulations, off-patent access Gx regulations favor generics

3. Future Market Projection

3.1 Projection Assumptions

Parameter Status / Data
Patent expiry dates Lamivudine in 2018, Zidovudine in 2020
Adoption of integrase inhibitors Increasing, reducing NNRTI-based regimen demand
Generic drug availability Expanding, driving prices down
Regional policies Favorability towards fixed-dose combinations and generics
Clinical trial outcomes No significant breakthroughs that extend drug lifespan

3.2 Market Forecast (2023–2033)

Year Projected Market (USD Billion) CAGR (%) Drivers Challenges
2023 3.1 - Existing demand, generics in low-income regions Competition from newer agents, resistance issues
2025 2.9 -2% Transition to integrase inhibitors Patent expiries, price decline
2030 2.1 -4% Reduced first-line usage, regulatory shifts Market consolidation, newer drugs dominate
2033 1.8 -3.5% Continued generic commoditization Market saturation, minimal innovation

3.3 Strategic Implications

  • Generics Manufacturers: Opportunities in low-cost production and expanding access programs.
  • Pharmaceutical Innovators: Focus on combination therapies with next-generation agents; potential niche roles.
  • Health Authorities: Emphasis on cost-effective, accessible therapies, especially in resource-limited settings.

4. Comparative Analysis of Lamivudine, Nevirapine, and Zidovudine

Attribute Lamivudine Nevirapine Zidovudine
Mechanism of Action Nucleoside reverse transcriptase inhibitor NNRTI Nucleoside reverse transcriptase inhibitor
First Approved 1995 1996 1987
Patent Status Expired (2018); generic available Off-patent in many regions Off-patent in many regions
Resistance Development Rate Moderate Higher in NNRTI class Moderate
Main Market Use First-line combo components, pediatric regimens Special populations, resistance issues Pediatric, certain monotherapy settings
Pharmacokinetics Once daily, well tolerated Twice daily, hepatotoxicity concerns Once daily, well tolerated in children

5. Key Regulatory and Policy Context

  • WHO Guidelines (2021): Emphasize integrase inhibitor-based regimens (e.g., Dolutegravir) as first-line, impacting NNRTI demand.
  • GAVI and UNITAID: Support large-scale procurement of generics like lamivudine and zidovudine.
  • Patent and Licensing: Patents for lamivudine in key markets expired in 2018, enabling rapid generic proliferation; zidovudine's patent expired in 2005.

Key Takeaways

  • Market Decline but Sustained Demand: The global market for lamivudine, nevirapine, and zidovudine is expected to decline at a CAGR of approximately -2.5% to -4% through 2033 due to a shift toward integrase inhibitors.
  • Generics Dominate: Patent expirations have facilitated access, especially in Africa and Asia, where demand remains high for budget-friendly formulations.
  • Clinical Trials Focus: Ongoing efforts prioritize resistance management, pediatric use, safety profiles, and bioequivalence, reinforcing the importance of these drugs in resource-limited settings.
  • Regulatory Trends: Efforts to phase out NNRTIs in favor of newer agents may reduce future use but sustain market relevance through generics and pediatric formulations.
  • Strategic Outlook: Manufacturers should leverage patent expirations and focus on low-cost generics, while innovators invest in combination therapies that align with evolving treatment guidelines.

FAQs

1. What are the clinical developments that could extend the lifespan of these drugs?
Research into resistance mitigation strategies, new formulations with improved safety profiles, and combination therapies that include these agents may sustain their relevance in specific niches, particularly in low-resource environments.

2. How will the shift to integrase inhibitors impact the market for Lamivudine, Nevirapine, and Zidovudine?
The adoption of integrase inhibitor-based regimens (e.g., Dolutegravir) in global guidelines is expected to reduce demand for NNRTIs and thymidine analogs, leading to declining revenues, but existing formulations will still see use through current inventories and in resource-constrained settings.

3. Which regions are most likely to continue using these drugs?
Sub-Saharan Africa and parts of Southeast Asia maintain high demand due to cost-effective, generic-based procurement and established treatment guidelines.

4. Are there emerging therapies that could replace these drugs entirely?
Yes, newer drug classes like integrase strand transfer inhibitors (e.g., Dolutegravir, Bictegravir) are becoming the mainstay in first-line therapy, with better safety and resistance profiles.

5. What are the implications of patent expirations?
Patent expirations in key markets have enabled the entry of low-cost generics, increasing accessibility. However, they also accelerate market saturation and price competition, pressuring brand-name producers.


References

  1. ClinicalTrials.gov database (2023). "Search: Lamivudine, Nevirapine, Zidovudine."
  2. WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment, and Care (2021).
  3. IMS Health Data (2015–2023). Worldwide HIV drug market analytics.
  4. GLOBOCAN 2020. HIV/AIDS prevalence and drug use statistics.
  5. Patent expiration records and regulatory filings, USPTO and EMEA databases (2018–2022).

This comprehensive analysis aims to inform pharmaceutical companies, healthcare policymakers, and investors to make scientifically grounded decisions regarding the future of lamivudine, nevirapine, and zidovudine in the global antiretroviral market.

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