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Review
. 2020 Jan;15(1):19-26.
doi: 10.1097/COH.0000000000000597.

Long-acting injectable cabotegravir for the prevention of HIV infection

Meredith E Clement  1 , Ryan Kofron, Raphael J Landovitz
Affiliations
Review

Long-acting injectable cabotegravir for the prevention of HIV infection

Meredith E Clement et al. Curr Opin HIV AIDS. 2020 Jan.

Abstract

Purpose of review: This review highlights the development of long-acting injectable cabotegravir (CAB LA) for HIV preexposure prophylaxis (PrEP), with a focus on phase 2 studies and later development.

Recent findings: Early studies of CAB LA for HIV prevention offered promising pharmacokinetic data and paved the way for phase 2 studies, which have now been completed. On the basis of phase 2 data, dosing of CAB LA at 8-week intervals consistently delivers target trough concentrations in both men and women. Recent studies have shown no required dose adjustments for hepatic or renal disease and minimal drug--drug interactions. Additionally, injectable PrEP is desired by potential PrEP candidates. Still, gaps in knowledge remain with respect to implementation and delivery, the clinical significance of the pharmacologic tail, and dosing in key populations. Phase 3 trials are underway that are anticipated to inform some of these questions and provide efficacy and safety data to support regulatory submissions for CAB LA as a potential PrEP agent.

Summary: Recent studies have defined an appropriate CAB LA dosing interval and offered insight into its safety profile. Phase 3 studies will provide much-anticipated efficacy data. If efficacious, CAB LA may provide a desirable PrEP option for those who face challenges to daily pill adherence. A more complete understanding of how to best integrate LA PrEP into service delivery models will be critical for success.

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Conflict of interest statement

Conflicts of interest

RJL is an Advisory Board member for Gilead Sciences and Merck and receives consultation fees from Roche. MEC receives consulting fees from FHI360.

Figures

Figure 1.
Figure 1.. Past, Ongoing, and Future CAB LA Development.
MSM, men who have sex with men; TGW, transgender women; Q4W, every 4 weeks; Q8W, every 8 weeks
Figure 2.
Figure 2.. Simulated and Observed CAB Concentrations of Men Enrolled in ECLAIR
PK, pharmacokinentic; ng, nanogram; mL, milliter; PA-IC90, protein binding–adjusted 90% inhibitory concentration; LLOQ, lower limit of quantification; mg, milligram
See this image and copyright information in PMC

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