CROI 2019—Monthly CAB+RPV noninferior to 3-drug ART in ATLAS


  • Jim Kling
  • Conference Reports
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Takeaway

  • Switching to a combination of long-acting cabotegravir and rilpivirine (CAB+RPV LA) injected monthly was noninferior to continued 3-drug antiretroviral therapy (ART) out to 48 weeks in ATLAS.

Why this matters

  • If approved, the combination would be the first long-acting therapy for HIV.

Study design

  • Open-label study (ATLAS): 616 participants were randomly assigned to continue receiving ART or switch to CAB+RPV LA.
  • Patients had HIV-1 RNA
  • Funding: Janssen; GlaxoSmithKline; ViiV.

Key results

  • At 48 weeks, 1.6% of patients in the CAB+RPV LA group had HIV RNA ≥50 copies/mL compared with 1.0% in the continued ART group, which met the noninferiority criteria.
  • At 48 weeks, 93% of patients in the CAB+RPV LA group had HIV RNA
  • 3 CAB+RPV LA patients and 4 continued ART patients experienced virologic failure.
  • 75% of the CAB+RPV LA group experienced injection site pain; 1% withdrew as a result.
  • Grade 3 or 4 adverse events: CAB+RPV LA, 11%; continued ART, 7%.
  • 98% of participants who completed to week 48 reported greater satisfaction with CAB+RPV LA vs oral therapy.

Limitations

  • CAB+RPV LA is not yet approved.

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