Long-acting HIV injections may relieve patients of the need for a lifelong regimen of daily pills, according to a press release from ViiV Healthcare, described in a Science report.
Daily pills are necessary for HIV patients to avoid developing AIDS, and to limit the likelihood of passing the disease to others. For many, this can present a challenge, in the form of “pill fatigue,” the psychological burden of daily reminders of the disease, and even difficulty swallowing for some patients. Yet, missed doses are not only a danger to the patient, but to others, as it can lead to the development of drug resistant strains of HIV.
Yet, a shareholder announcement earlier this month from ViiV Healthcare, a joint venture between Pfizer and GlaxoSmithKline, says that monthly injections may be able to replace such regimens. The 48-week study, called Antiretroviral Therapy as Long-Acting Suppression (ATLAS), tested the use of ViiV’s medication, cabotegravir, paired with rilpivirine, a drug licensed from Janssen Sciences. A total of 618 HIV patients from 13 countries were included in the study, all of which had their virus suppressed for 6 months with oral medications prior to the study. Half switched to the monthly injections of the two drugs, while the rest stayed on the pill regimen.
According to the statement from ViiV, the virus was suppressed equally in both groups at the end of the study.
Studies have shown 30 percent of HIV patients have trouble sticking with their treatment, even those on a single daily dose.
ViiV Research and Development chief Kimberley Smith says the new approach could help solve this problem, noting that “I experienced having patients die … because they just couldn’t get over that hurdle of taking that pill every day.”
Often, uninfected people at risk of being exposed to the virus are also hesitant to accept a daily regimen of pills, which is necessary for pre-exposure prophylaxis (PrEP). The long-acting injections could also prove a more acceptable option in these cases.
Other researchers are exploring a range of approaches to long-acting HIV treatments, including work by Merck & Co toward a pill that inhibits one HIV enzyme for as long as ten days. Researchers are also looking into slow-release skin implants and slow-dissolving pills to extend the effect of antiretroviral medications.
Companies could apply for regulatory approval as soon as 2019. However, questions remain as to the cost of the medications, how many patients would choose injections over pills, and the possibility that drugs which remain in the body for a longer period could increase the likelihood of drug-resistant strains emerging.