Cabotegravir/rilpivirine injection for HIV-infected patient treatment
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Abstract
Long-acting (LA) intramuscular (IM) Cabotegravir (CAB) and Rilpivirine (RPV) extended-release sterile injections were approved in The United States of America in 2021 for the treatment of HIV patients who were virological suppressed adults (HIV-1 RNA < 50 copies/ml), of 18 years or older, with no history of treatment failure, and with no known or resistance to cabotegravir or rilpivirine. Intramuscular administration of cabotegravir and rilpivirine leads to differences in pharmacokinetic property compared to conventional oral antiretroviral therapy. The difference is the long elimination half-life with intramuscular administration, which is more than 5 weeks of time, allowing it to be given monthly or every-two-months for the treatment of HIV. LA IM CAB/RPV are considered as an alternative choice for treating HIV especially patients with medication nonadherence. According to the clinical studies, the efficacy of LA IM CAB/RPV was noninferior to standard oral therapy for maintaining HIV-1 suppression. Injection site reactions were the most adverse event in using IM CAB/RPV e.g., pain, red and swelling, and pruritus. Cost-effectiveness analysis of IM CAB/RPV versus standard oral ART in the treatment HIV-1 summarized that IM CAB/RPV was more cost-effective, however the cost-effectiveness is still unclear because of the few studies.
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