NICE Approves Bimonthly Cabotegravir Injections for Select HIV PrEP Users
Long-acting injectables address adherence barriers in HIV but introduce clinic-visit dependence and higher upfront costs. Observational data show improved viral control in inconsistent oral users, yet real-world persistence beyond 12 months is unproven. Next studies must track resistance emergence and equity across income settings.
The MedicalXpress piece highlights adherence challenges and waste but omits quantitative efficacy data from the underlying trials. ATLAS and FLAIR phase 3 studies in NEJM 2020 showed long-acting cabotegravir plus rilpivirine maintained viral suppression in 93% of participants versus 93-95% on daily oral regimens, with non-inferiority margins met at 48 weeks. HPTN 083 and 084 trials for PrEP demonstrated 66% and 89% relative risk reductions in HIV acquisition among cisgender men and women, respectively, though absolute incidence remained low at 1-2 per 100 person-years in both arms.
UKHSA: By end-2027, fewer than 8,000 patients will initiate long-acting cabotegravir regimens under NHS criteria.
Sources (3)
- [1]ATLAS and FLAIR Trials(https://www.nejm.org/doi/full/10.1056/NEJMoa1904398)
- [2]HPTN 083/084 PrEP Results(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31794-7/fulltext)
- [3]NICE Cabotegravir Appraisal(https://www.nice.org.uk/guidance/ta756)