Yes, These Injectables Work Better Than Pills

If you’re like most people, maintaining a daily regimen of drugs can be burdensome and fraught with mishaps: missing a dose, taking them late, or losing them while traveling. Injections—frequently given monthly—offer the promise of less planning, interruption, and worry.

New research presented at the 21st Annual AIDS Conference in Durban, South Africa, offered good news for those living with HIV. Two long-acting injectable antiretrovirals succeeded in maintaining viral loads at undetectable levels in 90 percent of the HIV-positive participants who switched from taking daily pills.

David Margolis, MD, from ViiV Healthcare, presented findings from the LATTE-2 trial, which tested an injected formulation of the Edurant pill.

Newly diagnosed HIV-positive participants were put on 30 mg oral cabotegravir plus abacavir/lamivudine for 20 weeks. Those achieved viral suppression were then randomly broken into three groups: those remaining on the oral pill regimen; those switched to long-acting 400 mg cabotegravir and 600 mg rilpivirine injected every four weeks; and those who switched to 600 mg cabotegravir plus 900 mg rilpivirine injected every eight weeks.

All of the regimens worked. Forty-eight weeks into the new regimens, 92 percent of those who switched to injectables given every two months and 91 percent of those on the monthly shots maintained undetectable viral loads. Of those taking pills, 89 percent also remained undetectable.

Administered by a doctor once every four or eight weeks, long-acting injectables are a particularly appealing option for people living with HIV, who face a lifetime of antiretroviral treatment.

But Beta pointed out that “the potential drawback of this kind of treatment is that long-acting drugs cannot be removed from the body if problems occur.” In other words, if you do have negative side effects, you’ll have to endure them for the duration, as the drugs finish coursing through your body’s system.  

Deanna Kerrigan of Johns Hopkins Bloomberg School of Public Health also reported her findings around long-acting injectables. Her research found that people with HIV taking injectables said that the side effects of the injectables were worth putting up with, especially because the participants found the long-acting injectables simpler and more convenient than taking pills. Some subjects said the injections offered them greater confidentiality, while others said being on the long-acting injectables reduced the stigma they felt by removing the daily reminder that they were living with HIV.

The LATTE-2 trial continues; the monthly version has been approved for phase three studies planned later this year. Researchers will also be investigating how the injections will work with pre-exposure prophylaxis (PrEP).