Enter cabotegravir, an integrase inhibitor formerly known as S/GSK1265744 or 744. The drug has been under study for years as a potential long-acting option, either taken orally or via parenteral injec-tion. For its Phase 2b study, cabo-tegravir was paired with rilpivirine, the FDA-approved once-daily NNRTI that allows for nanoformula-tion, making it ideal for further de-velopment as a long-acting drug.
This cabotegravir/rilpivirine duet is the star of the LATTE study, a uniquely designed induction-maintenance trial intended to quickly suppress a treatment-naive patient's viral load with multi-class, once-daily oral therapy and then switch them to the experimental regimen after 24 weeks. The dose-ranging trial yielded comparable virologic efficacy for the induction-maintenance approach to the cur-rent efavirenz-based standard of care, Sax said.
Next up for this unique drug combo is the LATTE-2 study, which will examine the relative efficacy and safety of cabotegravir/rilpivirine injected intramuscularly either once every four weeks or once every eight weeks.
While LATTE-2 progresses, long-acting antiretrovirals are also being explored for another key use, Sax noted: pre-exposure prophylaxis (PrEP). "If the major problem with pre-exposure prophylaxis is adher-ence, what better way to take ad-herence out of the picture than to
give an injectable agent every three months?" Sax asked.