Dr. Swindells speaks on potential breakthrough in HIV treatment

Susan Swindells, M.B.B.S., professor of internal medicine-infectious diseases at UNMC and medical director of the Nebraska Medicine HIV Clinic, presented results earlier this month in Seattle about a study that showed a two-drug monthly injection was found as effective as a daily oral three-drug regimen for people with human immunodeficiency virus type-1 (HIV-1).

Dr. Swindells presented during an international conference on one of two phase III studies on the long-acting drug injection regimen using cabotegravir and rilpivirine.

The two studies — ATLAS (Antiretroviral Therapy as Long-Acting Suppression) and FLAIR (First Long-Acting Injectable Regimen) showed that the combination of the two drugs injected every four weeks, was just as effective in maintaining viral suppression in adults infected with HIV-1 as the standard of care — a daily, oral three-drug regimen.

Cabotegravir is manufactured by ViiV Healthcare, while rilpivirine is manufactured by Janssen Pharmaceutical. Data were presented at the 2019 Conference on Retroviruses and Opportunistic Infections.

“The positive safety and efficacy results from the ATLAS study reinforce the potential of cabotegravir and rilpivirine as the first long-acting, injectable option for people living with HIV,” said Dr. Swindells, principal investigator for the ATLAS study. “This novel approach may help alleviate the burden often associated with daily oral treatment regimens and contribute to making HIV a smaller part of peoples’ lives.”

The ATLAS study is part of ViiV Healthcare’s innovative clinical trial program for two-drug regimens. The international study included 616 men and women living with HIV. It was conducted at research centers in Argentina, Australia, Canada, France, Germany, Italy, Mexico, Russia, South Africa, South Korea, Spain, Sweden, and the United States.

Dr. Swindells said the long-acting injection therapy is a new approach for delivering HIV care. “The injections use similar drugs as the pill forms that patients now take every day. There’s great interest in the medical and scientific community as well as for patients with HIV. We’re hoping to get it approved by the Food and Drug Administration next year.

“It’s always nice to be able to offer patients different options. Some people don’t want to take pills every day, and some have difficulty taking pills for various reasons.”

“We are also encouraged by patient preference data showing that nearly all participants who switched to the long-acting injectable regimen preferred it over their prior oral therapy,” said John C. Pottage, Jr., M.D., chief scientific and medical officer of ViiV Healthcare. “If approved, this two-drug regimen would give people living with HIV one month between each dose of antiretroviral therapy, changing HIV treatment from 365 dosing days per year, to just 12.”