Long-acting injectable Cabenuva works well in people with obesity, according to research presented at the European AIDS Conference. Cabenuva consists of an extended-release formulation of ViiV Healthcare’s new integrase inhibitor, cabotegravir, plus an injectable version of the NNRTI rilpivirine. It involves two separate shots in the buttocks administered by a health care provider.

The Phase III ATLAS and FLAIR trials showed that more than 90% of people who received Cabenuva maintained viral suppression at 48 weeks. The follow-up ATLAS-2M study found that every-other-month administration works as well as once monthly.

Some drugs can be metabolized and distributed differently depending on body weight, so ViiV scientists conducted a pooled analysis of the three trials, stratifying participants by body mass index (BMI); 154 people who received Cabenuva once monthly and 59 of those treated every other month had a BMI of 30.0 or greater (classified as obesity).

Among participants with obesity, 92% had an undetectable viral load at 48 weeks, similar to the rate for those classified as normal or overweight. However, people with obesity were more likely than people with normal weight or overweight to have a viral load above 50, especially on the every-other-month regimen. No participants with obesity experienced severe side effects.

Looking at drug levels, cabotegravir and rilpivirine trough concentrations (the lowest level between doses) remained above the target level known to suppress HIV, regardless of BMI. But the researchers found that using a longer 2-inch needle led to higher cabotegravir trough concentrations for people with obesity.