HIV infection is currently managed as a chronic disease because of improvements in antiretroviral therapy (ART). Switching to a new regimen is a natural event during long-term therapy to avoid problems related to toxicity, adherence, failure, and potential selection of drug resistance. The development of co-formulations of multiple agents in one pill, and novel drug classes and drugs with a high genetic barrier to resistance have been important in this context. The approval of the long-acting, once-monthly or bimonthly injectable combination of the second-generation strand transfer integrase inhibitor (InSTI), cabotegravir (CAB) together with the non-nucleoside reverse transcriptase inhibitor (NNRTI), rilpivirine (RPV) represents the most recent achievement in the search for potent and convenient ART. Several pivotal trials (such as LATTE-2, ATLAS, FLAIR, and ATLAS-2M) showed the high efficacy and safety of this long-acting formulation used as an induction-maintenance strategy. Few confirmed virological failures (CVF) have been observed. The combination of at least two of the following baseline factors, HIV-1 subtype A6/A1, a body mass index (BMI) ≥30 kg/m2, and RPV resistance-associated mutations, was associated with an increased risk of CVF at week 48. The data indicate that this long-acting therapeutic strategy is attractive and potent; therefore, defining the most appropriate patient for this treatment and how to handle practical issues is warranted.

Rusconi, S., Santoro, M., Capetti, A.f., Gianotti, N., Zazzi, M. (2022). The future of long-acting cabotegravir plus rilpivirine therapy: deeds and misconceptions. INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 106627 [10.1016/j.ijantimicag.2022.106627].

The future of long-acting cabotegravir plus rilpivirine therapy: deeds and misconceptions

Santoro, Maria;
2022-06-24

Abstract

HIV infection is currently managed as a chronic disease because of improvements in antiretroviral therapy (ART). Switching to a new regimen is a natural event during long-term therapy to avoid problems related to toxicity, adherence, failure, and potential selection of drug resistance. The development of co-formulations of multiple agents in one pill, and novel drug classes and drugs with a high genetic barrier to resistance have been important in this context. The approval of the long-acting, once-monthly or bimonthly injectable combination of the second-generation strand transfer integrase inhibitor (InSTI), cabotegravir (CAB) together with the non-nucleoside reverse transcriptase inhibitor (NNRTI), rilpivirine (RPV) represents the most recent achievement in the search for potent and convenient ART. Several pivotal trials (such as LATTE-2, ATLAS, FLAIR, and ATLAS-2M) showed the high efficacy and safety of this long-acting formulation used as an induction-maintenance strategy. Few confirmed virological failures (CVF) have been observed. The combination of at least two of the following baseline factors, HIV-1 subtype A6/A1, a body mass index (BMI) ≥30 kg/m2, and RPV resistance-associated mutations, was associated with an increased risk of CVF at week 48. The data indicate that this long-acting therapeutic strategy is attractive and potent; therefore, defining the most appropriate patient for this treatment and how to handle practical issues is warranted.
In corso di stampa
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/07
English
HIV
antiretroviral therapy
cabotegravir
integrase inhibitors
long-acting
rilpivirine
Rusconi, S., Santoro, M., Capetti, A.f., Gianotti, N., Zazzi, M. (2022). The future of long-acting cabotegravir plus rilpivirine therapy: deeds and misconceptions. INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 106627 [10.1016/j.ijantimicag.2022.106627].
Rusconi, S; Santoro, M; Capetti, Af; Gianotti, N; Zazzi, M
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/304397
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