# Discontinuation of Long-acting Injectable Cabotegravir–Rilpivirine in a Large Clinic Cohort

## TL;DR

A study finds that one in six HIV patients stopped using a long-acting injectable drug due to pain and adherence issues, but most remained virus-free on alternative treatments.

## Contribution

The study provides real-world data on discontinuation rates and outcomes of long-acting injectable HIV treatment outside clinical trials.

## Key findings

- One in six HIV patients discontinued the injectable drug cabotegravir-rilpivirine within 18 months.
- Most patients who stopped the drug maintained viral suppression on alternative antiretrovirals.
- Injection-related pain and adherence challenges were common reasons for discontinuation.

## Abstract

Little is known about long-acting injectable cabotegravir-rilpivirine discontinuation outside clinical trials. In a large clinic cohort, 1 in 6 people with HIV discontinued long-acting injectable cabotegravir-rilpivirine over a median of ∼18 months. Injection-related pain was common. Virologic failure and efficacy concerns drove discontinuation for people with HIV with adherence challenges. Most had viral suppression on alternate antiretrovirals post-discontinuation.

In a large U.S. based clinic cohort of people with HIV (PWH) using long-acting cabotegravir-rilpivirine, 1 out of 6 discontinued over a median follow-up of eighteen months. Viral suppression on alternate antiretroviral therapy after discontinuation was high, even in the small number of cases with treatment-emergent resistance mutations.