Promising research suggests that long-acting antiretrovirals (ARVs) that allow for dosing every one to two months may become a reality. A Phase IIb trial examined a regimen of daily oral versions of the integrase inhibitor GSK744 and the reverse transcriptase inhibitor Edurant (rilpivirine), comparing it with a standard triple cocktail of Sustiva (efavirenz) and two nucleoside reverse transcriptase inhibitors. The two regimens proved comparable in their ability to suppress HIV.
This study opens the door for a trial of long-acting therapy with intramuscular injections of GSK744 and Edurant given every four to eight weeks.
A long-acting version of GSK744 is already being investigated as a form of pre--exposure prophylaxis (PrEP) and has shown promise in primate trials in its ability to protect against both vaginal and rectal transmission to SIV, HIV’s simian cousin. Meanwhile, a long-acting form of Edurant is currently being developed.
“I have a lot of patients who take their medications every day, but really would prefer not to have to look at a bottle of Atripla every day and be reminded that they’re HIV positive,” says Tony Mills, MD, an HIV specialist in West Hollywood. “So I think for people who would like to do the shot every month or two months it would be a very useful therapy.”