The AIDS division at the U.S. National Institutes of Health has announced the superior efficacy of cabotegravir, an investigative injectable drug under development for HIV prevention and treatment.
Cabotegravir is made by ViiV Healthcare.
US National Institute of Health is the primary sponsor of a recent study on cabotegravir. The drug is injected into the buttocks every two months.
According to the researchers cabotegravir is far more effective than daily oral Truvada at preventing HIV acquisition among cisgender men who have sex with men and transgender women who have sex with men.
While both methods were highly effective for HIV prevention in the study population, the final data analysis indicated that cabotegravir had a superior protective effect.
This is based on new data analysis of HPTN 083, a study from the HIV Prevention Trials Network that enrolled over 4,500 cisgender men who have sex with men, and transgender women who have sex with men in the United States, Brazil, Peru, Argentina, South Africa, Thailand, and Vietnam to compare ViiV Healthcare’s injectable cabotegravir with Gilead Sciences’ pill Truvada.
In May 2020, a planned interim review of HPTN 083 data indicated a high level of efficacy for long-acting injectable cabotegravir among cisgender men and transgender women who have sex with men. The latest results are based on a more extensive analysis of interim data from 4,566 study participants.
New evidence shows #Cabotegravir — an investigative injectable drug for #HIV prevention and treatment — is 66% more effective than daily oral #PrEP. @UCLA’s Raphael Landovitz and other experts discuss the barriers to the drug’s rollout. @catherinecheney reports.
— Devex (@devex) July 7, 2020
When taken daily, PrEP provides between a 92% and 99% reduction in HIV risk. But because people don’t always take their pills as prescribed, there is a demand for long-acting HIV prevention tools.
While there is sure to be excitement around cabotegravir’s effectiveness at AIDS 2020, the conference where the final data analysis from the study was revealed, a number of barriers stand in the way for this drug to deliver on its promise to reduce HIV transmission.
“The challenge that we’ve observed is the same populations who are disproportionately affected by HIV also have had challenges accessing, uptaking, adhering to, persisting with something that requires a daily oral pill,” said Raphael Landovitz, a professor at the University of California, Los Angeles who served as protocol chair of HPTN 083.
As impressive as the results of the HPTN 083 study may be, and as promising as it sounds to reduce dosing from daily to six times a year, it remains to be seen how providers in fragile health systems further strained by COVID-19 can deliver an injection every two months to people most at risk of HIV.
“I’d love to be optimistic,” Shannon Hader, deputy director at UNAIDS, said about cabotegravir at the opening press conference of AIDS 2020. For many people, injectable cabotegravir may be an easier intervention than a daily pill, but demand generation is still key, she said.
The partners working on getting cabotegravir from the lab to the field can learn from the problems that arose with daily oral PrEP, several experts told Devex.
In 2012, Truvada became the first drug approved to reduce the risk of sexually acquired HIV infection.
