An inventory of important matters that need to be paid attention to when using cabotegravir/rilpivirine injection suspension

Cabotegravir/rilpivirine injection suspension (cabotegravir and rilpivirine) , trade name: Cabenuva, is a long-acting injection treatment for adults and adolescents aged 12 years and above. The drug consists of cabotegravir and rilpivirine, which serve as HIV-1 integrase strand transfer inhibitors and non-nucleoside reverse transcriptase inhibitors respectively, bringing new options to the HIV treatment field.

Cabotegravir/Rilpivirine injection suspension has shown good antiviral therapeutic effects in clinical trials. FLAIR and ATLAS Two phase 3 randomized, multicenter, active-controlled, parallel-arm and open-label non-inferiority clinical trials enrolled 1245 subjects who had achieved virological suppression. The trial results show that regardless of the monthly dosage regimen or the every 2monthly dosage regimen, the therapeutic effect of the cabotegravir/rilpivirine group is equivalent to that of the control group, and the plasmaHIV-1 The proportion of subjects with RNArebounding to 50 copies/mL or above was very low, verifying its stable and reliable antiviral effect.

However, there are some important considerations for patients and physicians when using cabotegravir/rilpivirine injection suspension. First, this drug may cause hypersensitivity reactions when used in combination with integrase inhibitors, and should be discontinued immediately if relevant signs or symptoms occur. Secondly, serious injection site reactions may occur after injection, which require close monitoring and prompt treatment. In addition, hepatotoxicity and depression have been reported in a small number of patients, so liver biochemical indicators should be regularly monitored and depressive symptoms should be promptly assessed. If treatment fails, an alternative antiretroviral regimen should be initiated promptly.

At the same time, it should be noted that this product is prohibited for people with hypersensitivity reactions to cabotegravir or rilpivirine and pregnant women. This product also interacts with certain drugs, especially when co-administered with drugs that induce UGT1A1 or CYP3A4, it may reduce the drug concentration and lead to treatment failure, so drug interactions need to be cautious.

2021Year1Month21On August 1, this innovative drug was approved by the U.S. Food and Drug Administration and officially launched on the market. The European version of the original drug is expensive, reaching more than 10,000 yuan. However, unfortunately, this drug is not currently on the market in my country, and patients need to obtain it through local hospital pharmacies or regular overseas medical consulting agencies.

In summary, cabotegravir/rilpivirine injection suspension provides a new treatment option for HIV infected patients, but it is necessary to pay close attention to possible adverse reactions and drug interactions during use to ensure the safety and effectiveness of the treatment.

Reference link:https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/212888s011lbl.pdf