Long-Acting Injectable Therapy – Real-World Evidence
Key Themes:
- Injectable Option: Cabotegravir (integrase inhibitor) plus rilpivirine as an intramuscular injection given every other month
- Real-World Performance: The OPERA cohort followed nearly 3000 US patients receiving this combination outside clinical trials.
- Adherence Challenges: Importance of timely injections, with 62% of patients receiving injections on schedule and 12% missing injections
- Clinical Implications: Risk of resistance development if injections are delayed or missed
Notable Insights from Dr Sharon Walmsley:
- Real-world virologic suppression rates exceeded 95%, with less than 1% experiencing virologic failure, mirroring clinical trial results.
- High body mass index was not associated with treatment failure in this cohort, contrasting with some earlier studies, likely due to improved administration techniques (longer needles).
- Injectable therapy offers psychological benefits to patients who are “tired of swallowing pills” or find daily oral medication a constant reminder of HIV status.
- Clinics need systematic approaches to track and ensure timely administration of injections to prevent resistance development.
