Cabotegravir: New long-acting injectable
Summary
This is a brief summary of a long-acting injectable Cabotegravir (CAB-LA).
Introduction
Wow! A new HIV drug is on the market and it seems to be breaking new boundaries. Recently it was announced that Zimbabwe was the first African country to approve a drug called Cabotegravir (CAB-LA). The drug was approved by the European Union in 2020 and Zimbabwe approved it in October 2022. According to UNAIDS, the developer of the CAB-LA has already approached SAHPRA and the outcome of this should be out by 2022.
This new drug is classified as an integrase inhibitor, similar to Dolutgravir. Currently, Dolutegravir comes either as a single agent (50mg) or in a fixed drug combination such as TLD (300mg/300mg/50mg). The difference between Dolutegravir and Cabotegravir is that, unlike Dolutegravir, Cabotegravir has an injectable form. Cabotegravir may be injected intramuscularly as a single agent or in combination with Rilpivirine.
WHO approved and released guidelines for the use of long-acting injectable Cabotegravir (CAB-LA) for use in pre-exposure prophylaxis for HIV. The WHO website states that the first 2 injections are given 4 weeks apart, this is then followed by an injection every 8 weeks (2 months). According to the same article, it states that Cabotegravir has a 79% relative reduction in HIV risk when compared with oral pre-exposure prophylaxis.
Cabotegravir is a drug that one could consider as “still being researched“. This is due to the fact that there are still some gaps in the research in regard to issues such as safety in pregnancy and breastfeeding.
Interactions
Like many HIV antiretrovirals, Cabotegravir has several intereactions: Rifampicin, rifapentine, carbamazepine, oxcarbazepine, phenytoin or phenobarbital. These drugs significantly reduce the effect of Cabotegravir. Therefore, Cabotegravir should not be taken in patients who are using these agents.
Side Effects
Local site injection side effects (pain, swelling), fever, headache, and other less common such as insomnia and depressive disorders.
References and Further Reading
1. Guidelines on long-acting injectable cabotegravir for HIV prevention (no date) World Health Organization. World Health Organization. Available at: https://www.who.int/publications /i/item/9789240054097 (Accessed: October 26, 2022).
2. Unaids.org (2021) UNAIDS welcomes the approval of long-acting injectable cabotegravir as a pre-exposure prophylaxis for HIV prevention, UNAIDS. UNAIDS. Available at: https://www.unaids.org/en/ resources/presscentre/
pressreleaseandstatementarchive/ 2021/december / 20211222_cabotegravir (Accessed: October 26, 2022).
2. Unaids.org (2021) UNAIDS welcomes the approval of long-acting injectable cabotegravir as a pre-exposure prophylaxis for HIV prevention, UNAIDS. UNAIDS. Available at: https://www.unaids.org/en/ resources/presscentre/
pressreleaseandstatementarchive/ 2021/december / 20211222_cabotegravir (Accessed: October 26, 2022).
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