ViiV Healthcare’s long-acting Cabenuva (cabotegravir + rilpivirine) for HIV demonstrates superior efficacy compared to daily oral therapy for people with adherence challenges; results published in NEJM
- Final data from LATITUDE study show switch to long-acting injectable treatment reduced the risk of virological failure by nearly half for study participants through 48 weeks, compared to those continuing on daily oral therapy
The 48-week datawere published in The
LATITUDE (Long-Acting Therapy to Improve Treatment Success in Daily Life) is a phase III, randomised, open-label study which enrolled 453 participants who face challenges taking daily oral ART or who disengaged from HIV care. In the study, the median age was 40 years; 63% were Black/
The primary endpoint was a comparison of regimen failure between arms, defined as a combination of virologic failures (VF) and regimen discontinuation for any reason. The cumulative risk of regimen failure through 48 weeks of treatment was reduced by nearly half in the study: 22.8% for those who were switched to long-acting injectable cabotegravir + rilpivirine vs. 41.2% for people continuing on daily oral therapy (29/152 vs. 55/154, respectively).1
Among participants receiving long-acting cabotegravir + rilpivirine in the trial, 29/152 (19%) experienced regimen failure, five (3%) of whom had VF and 24 (16%) had permanent treatment discontinuation as their first event. In the daily oral therapy arm, 55/154 (36%) experienced regimen failure, among whom 32 (21%) had VF as their first event and 23 (15%) had permanent treatment discontinuation.1
Key additional endpoints at week 48 demonstrated the superiority of cabotegravir + rilpivirine vs. daily oral therapy:1
|
Endpoint |
Cumulative probability, long-acting injectable cabotegravir + rilpivirine (n=152) |
Cumulative probability, daily oral therapy (n=154) |
Cumulative incidence difference (98.4% CI) |
|
VF (events) |
6.8% (6) |
28.2% (34) |
-21.4% (-33.5%, -9.3%) |
|
Treatment-related failure* (events) |
8.9% (9) |
28.1% (34) |
-19.2% (-31.6%, -6.9%) |
|
Permanent discontinuation of treatment (events) |
19.8% (26) |
28.2% (37) |
-8.4% (-21.3%, 4.5%) |
* Earliest occurrence of VF or premature treatment discontinuation due to treatment-related adverse events (AEs).
The rate of AEs was similar in both arms. The most common AE in the long-acting arm was injection site reactions (ISRs), with two participants discontinuing due to an ISR.1 Two confirmed VF in each arm (n=4 total) had new resistance associated mutations (RAMs), including two new integrase inhibitor RAMs in both long-acting arm participants.1
Building on the LATITUDE study,
LATITUDE is sponsored and funded by the
About Cabenuva (cabotegravir + rilpivirine)
Cabenuva is indicated as a complete regimen for the treatment of HIV-1 infection in adults and adolescents 12 years and older and weighing at least 35 kg to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA <50 c/ml) on a stable antiretroviral regimen with no history of treatment failure and with no known or suspected resistance to either cabotegravir or rilpivirine.
The complete regimen combines the integrase strand transfer inhibitor (INSTI) cabotegravir, developed by
INSTIs inhibit HIV replication by preventing the viral DNA from integrating into the genetic material of human immune cells (T-cells). This step is essential in the HIV replication cycle and is also responsible for establishing chronic disease. Rilpivirine is an NNRTI that works by interfering with an enzyme called reverse transcriptase, which stops the virus from multiplying.
Please consult the full Prescribing Information here.
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About ACTG
ACTG is the world’s largest and longest running clinical trials network focused on HIV and other infectious diseases and the people living with them. It is funded by NIAID and collaborating
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References
- Rana A., et al. Cabotegravir plus Rilpivirine for Persons with HIV and Adherence Challenges. N Engl J Med. 2026.
-
Clinicaltrials.gov website. A Study to Evaluate the Effectiveness of Long-acting (LA) Cabotegravir (CAB) + Rilpivirine (RPV) LA When Given to Participants With Detectable HIV-1 (CROWN). Available at: https://clinicaltrials.gov/study/NCT06694805. Last accessed:
February 2026 .
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