Cabenuva Works Well Regardless of Body Weight

[Jim Allen]

Good to see a high % of people at week 48 had viral suppression (Viral load below 50)

https://www.poz.com/article/cabenuva-works-well-regardless-body-weight

At week 48, viral suppression rates were high and similar across groups. Among participants with obesity, 92.2% of those who received Cabenuva every month and 91.5% of those who did so every other month had a viral load below 50, compared with 92.7% and 94.0%, respectively, in the normal/overweight group.

However, people with obesity were more likely to have a viral load above 50 (4.5% on monthly and 6.8% on every-other-month Cabenuva), compared with the normal/overweight group (1.2% and 0.4%, respectively). More people with obesity stopped treatment due to lack of efficacy, while more normal/overweight participants did so due to adverse events or for other reasons. Eight people with obesity and five in the normal/overweight group met the criteria for confirmed virological failure. But no one in the former group had high BMI as their only risk factor; all also had either rilpivirine resistance mutations or an HIV subtype associated with treatment failure.

Cabenuva was safe and generally well tolerated, with comparable rates of adverse events across groups. No participants with obesity experienced severe drug-related adverse events, and only one stopped treatment because of an adverse event.

The most common side effect was injection site reactions, including pain, redness or swelling. People with obesity were somewhat less likely to report such reactions. The reactions were usually mild or moderate, transient (lasting a median of three days) and diminished over time.

Looking at drug levels, cabotegravir and rilpivirine trough concentrations (the lowest level between doses) remained above the target level known to suppress HIV, regardless of BMI. Median cabotegravir trough levels tended to be lower initially in people with obesity, but this trend disappeared by week 48, Elliott reported. Rilpivirine concentrations were unaffected by BMI.

But the researchers found that using a longer two-inch needle for injection led to higher cabotegravir trough concentrations for participants with obesity. They recommended that longer needles be used for people with a BMI over 30.0 to ensure appropriate administration into the gluteal muscle.