Effects of lenacapavir injection

Lenacapavir is a novel, first-in-class inhibitor of HIV-1 capsid function with efficacy at various stages of the viral life cycle. 4 It is indicated for the treatment of multidrug-resistant (MDR) HIV-1 infection in combination with optimized background antiretroviral therapy. 4 Lenacapavir has been approved by the USFDA, EMA, and Health Canada for treating MDR HIV-1 infection. 6

Major research findings

Lenacapavir has been shown to be effective and safe in adults with MDR HIV-1 infection when used in combination with an optimized background regimen for up to 52 weeks. 2 A favorable pharmacokinetic profile supports an every sixth month dosing interval of subcutaneous lenacapavir after an initial oral loading dose, which may advocate for continued adherence to antiretroviral therapy (ART) through the reduction of daily pill burden. 4 Lenacapavir has a unique mechanism of action that interferes with multiple stages of the HIV life cycle rather than with a single enzyme. 3 This suggests that lenacapavir may be less likely to lead to the development of drug resistance. 4

Lenacapavir can be administered orally or subcutaneously. 7 It has been shown to have additive or synergistic effects when combined with other antiretrovirals, such as rilpivirine, cabotegravir, islatravir, bictegravir, and tenofovir. 6 Lenacapavir is also an excellent drug for patients having difficult or limited access to healthcare facilities. 6

Benefits and risks

Benefits summary

Lenacapavir is a potent and well-tolerated drug with a unique mechanism of action that has the potential to be effective against drug-resistant HIV-1 strains. 4 The long-acting formulation of lenacapavir may improve adherence to treatment and reduce the burden of daily pill-taking. 4 Lenacapavir has the potential to be effective for both treatment and prevention of HIV-1 infection. 2 , 4

Risks summary

Lenacapavir has been shown to be generally well-tolerated in clinical trials. 4 The most common side effects include mild to moderate injection site reactions, gastrointestinal symptoms, and headache. 4 Lenacapavir is metabolized by CYP3A and UGT1A1, it is a substrate of Pgp and a moderate inhibitor of CYP3A. 3

Comparison between studies

Commonalities in studies

All of these studies show that lenacapavir is effective in treating MDR HIV-1 infection. 2 , 6 , 7 All of these studies show that lenacapavir is generally well-tolerated. 2 , 4 , 7

Differences between studies

These studies evaluate lenacapavir in different regimens. 2 , 7 Some studies evaluate lenacapavir in combination with other antiretrovirals. 2 , 7 , 4

Consistency and contradictions in the results

These studies show consistent results that lenacapavir is an effective drug for treating MDR HIV-1 infection. 2 , 6 , 7 However, data on the long-term safety and efficacy of lenacapavir are limited. 2 , 4

Considerations for real-world application

Lenacapavir appears to be a promising new treatment option for patients with MDR HIV-1 infection. 2 , 6 However, long-term safety and efficacy data are limited. 2 , 4 It is important to weigh the risks and benefits of lenacapavir with a healthcare professional.

Limitations of current research

Long-term safety and efficacy data on lenacapavir are limited. 2 , 4

Future research directions

More research is needed to assess the long-term safety and efficacy of lenacapavir. 2 , 4 Research is also needed to evaluate lenacapavir in different populations and to investigate how it interacts with other treatments for HIV-1 infection.

Conclusion

Lenacapavir is a promising new treatment option for patients with MDR HIV-1 infection. 2 , 6 Lenacapavir has the potential to be effective against drug-resistant HIV-1 strains. 4 However, more research is needed to assess the long-term safety and efficacy of lenacapavir. 2 , 4 It is important to discuss the risks and benefits of lenacapavir with a healthcare professional.