Many barriers exist with CAB/RPV implementation that may be easily managed. For successful implementation, intense collaboration among care team members, external support, and excellent communication are necessary. This article discusses the lessons from LA CAB/RPV injections and strategies to improve access and utilization.
What We’ve Learned and What We Can Look Forward To Read More »
Since 2021, the Ward 86 Clinic at the University of California, San Francisco (UCSF) has conducted a pilot study on injected CAB/RPV in patients with viremia. The study enrolled 133 patients who received injected CAB/RPV, 57 of whom had viremia. The mean log10 viral load of these 57 patients was 4.21, and the mean CD4
Microarray patches (MAPs) are currently under investigation as a self-administered, pain-free alternative used to achieve long-acting (LA) drug delivery. Cabotegravir is a potent antiretroviral with superior results over current pre-exposure prophylaxis (PrEP) regimens. This study aimed to apply physiologically based pharmacokinetic (PBPK) modeling to describe the pharmacokinetics of the dissolving bilayer MAP platform and predict
Intramuscular cabotegravir/rilpivirine (IM CAB/RPV) are metabolized by UGT1A1/CYP3A4. Efavirenz induces both enzymes; therefore, switching from an efavirenz-containing regimen to IM CAB/RPV could possibly result in suboptimal levels. Due to their long dosing interval, clinical studies with IM CAB/RPV are challenging. We used physiologically based pharmacokinetic (PBPK) modeling to simulate switching from efavirenz to IM CAB/RPV.
Reductions in HIV acquisition have slowed, and the global community is significantly off track from global goals. Oral pre-exposure prophylaxis (PrEP) alone cannot address the diverse needs of the millions of people at risk of HIV acquisition. Long-acting injectable cabotegravir (CAB-LA) received United States Food and Drug Administration approval for HIV prevention in December 2021.
This is a case report regarding a hemodialysis MDR HIV-infected patient who switched to fostemsavir with lenacapavir plus lamivudine for more than a year. She maintained a suppressed viral replication and presented no clinical or biological drug-related side effects. The combination of lenacapavir plus fostemsavir looks promising regarding safety and efficacy, even in patients with
Lenacapavir with Fostemsavir in a Multidrug-Resistant HIV-Infected Hemodialysis Patient Read More »
Despite the availability of safe and effective oral combination antiretroviral therapy, barriers to maintaining viral suppression remain a challenge to ending the HIV epidemic. Long-acting injectable antiretroviral therapy was developed as an alternative to daily oral therapy. This review summarizes the current literature on the efficacy of long-acting cabotegravir plus rilpivirine for the treatment of
The New Era of Long-Acting Antiretroviral Therapy: When and Why to Make the Switch Read More »
The purpose of this article is to review the pharmacology, efficacy, and safety of the capsid inhibitor lenacapavir for the treatment of multidrug-resistant human immunodeficiency virus type 1 (HIV-1) infection. A review of the literature was performed by searching PubMed/MEDLINE for all relevant articles published between February 2021 and March 2023 using the keywords “lenacapavir,”
“Treatment with long-acting (LA) ART may improve adherence and health-related quality of life. The objective of this study was to evaluate the cost-effectiveness of cabotegravir + rilpivirine (CAB+RPV) LA administered every 2 months (Q2M) compared with current ART administered as daily oral single-tablet regimens (STRs) from a Spanish National Healthcare System perspective. This study demonstrated
Data support the use of long-acting cabotegravir plus rilpivirine dosed every 2 months as a complete antiretroviral regimen that has similar efficacy to a commonly used integrase strand transfer inhibitor-based first-line regimen while addressing unmet psychosocial issues associated with daily oral treatment.
