Study Assesses Once-Monthly Cabotegravir Plus Rilpivirine Injections as HIV Maintenance Therapy
New study results support the use of once-monthly injection of long-acting cabotegravir (CAB LA) plus long-acting rilpivirine (RPV LA) compared with the standard treatment of 3-drug combination oral antiretroviral therapy (cART) in adults with virologically suppressed HIV-1 infection.
The Antiretroviral Therapy as Long Acting Suppression (ATLAS) study is an ongoing, multistage, phase 3, open label, multicenter study with the goal of determining whether adults with HIV-1 infection with viral suppression on an oral cART regimen of 2 nucleoside reverse-transcriptase inhibitors plus a third agent (an integrase inhibitor, a nonnucleoside reverse-transcriptase inhibitor, or a protease inhibitor) maintain viral suppression upon switching to the 2-drug regimen of intramuscular CAB LA, 400 mg, plus RPV LA, 600 mg, every 4 weeks.
Lead author Susan Swindells, MD, a professor in the Department of Internal Medicine and the medical director of the Specialty Care Clinic at the University of Nebraska Medical Center in Omaha, discussed the study results earlier this week at the Conference on Retroviruses and Opportunistic Infections (CROI) 2019 in Seattle, Washington.
The ATLAS study enrolled 616 adult participants with HIV-1 infection, with 308 participants in each treatment arm. At 48 weeks, 5 participants (1.6%) in the LA arm and 3 (1.0%) in the cART arm had viral suppression as indicated by HIV-1 RNA ≥50 copies/mL, demonstrating the noninferiority of the LA regimen to the cART regimen.
Dr Swindells noted that the once-monthly LA regimen was generally well tolerated, with low rates of serious adverse events and drug- or injection site–related withdrawals. She also noted that virologic failure was infrequent in both treatment groups.
The study also found a significantly greater increase in treatment satisfaction among participants taking the monthly LA regimen over time vs the oral cART regimen.
“Overall, these results support the therapeutic potential of monthly cabotegravir and rilpivirine long-acting,” Dr Swindells concluded.
For more information about this study, click here.
For more CROI 2019 coverage, click here.
—Michael Gerchufsky
Reference:
Swindells S, Andrade-Villanueva J-F, Richmond GJ, et al. Long-acting cabotegravir + rilpivirine as maintenance therapy: ATLAS week 48 results. Presented at: Conference on Retroviruses and Opportunistic Infections (CROI) 2019; March 4-7, 2019; Seattle, WA. http://www.croiconference.org/sessions/long-acting-cabotegravir-rilpivirine-maintenance-therapy-atlas-week-48-results. Accessed March 8, 2019.