A Narrative Review of Novel Agents for Managing Heavily Treatment-Experienced People Living With HIV.

Objective: The objective of this review is to compare ibalizumab, fostemsavir, and lenacapavir, present the clinical trials evaluating each agent, and provide guidance on their use in highly-treatment experienced (HTE) population living with HIV (PWH). Data sources: A search of PubMed and clinicaltr...

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Publicado en:Journal of Pharmacy Technology Vol. 40; no. 4; pp. 194 - 202
Autores principales: Beran, Christina, Duggan, Joan M., Sahloff, Eric G.
Formato: review tables/charts Journal Article
Publicado: Sage Publications Inc. Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: A Narrative Review of Novel Agents for Managing Heavily Treatment-Experienced People Living With HIV.
      aug:
        au:
          Beran, Christina
          Duggan, Joan M.
          Sahloff, Eric G.
        affil: College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH, USA
      sug:
        subj:
          Antiretroviral Therapy, Highly Active
          HIV-Positive Persons Psychosocial Factors
          HIV Infections Drug Therapy
          Antibodies, Monoclonal Therapeutic Use
          Anti-HIV Agents Therapeutic Use
          Anti-Retroviral Agents Therapeutic Use
          Antibodies, Monoclonal Administration and Dosage
          Anti-HIV Agents Administration and Dosage
          Anti-Retroviral Agents Administration and Dosage
          Antibodies, Monoclonal Pharmacokinetics
          Anti-HIV Agents Pharmacokinetics
          Anti-Retroviral Agents Pharmacokinetics
          Drug Interactions
          Drug Resistance
          Virology
          Clinical Trials
      ab: Objective: The objective of this review is to compare ibalizumab, fostemsavir, and lenacapavir, present the clinical trials evaluating each agent, and provide guidance on their use in highly-treatment experienced (HTE) population living with HIV (PWH). Data sources: A search of PubMed and clinicaltrials.gov was conducted using the search terms: ibalizumab, fostemsavir, and lenacapavir. Study selection and data extraction: English-language, clinical publications were included. Data synthesis: Ibalizumab, fostemsavir, and lenacapavir, are each first-in-class agents, that have major differences in mechanism of action, route and frequency of administration, pharmacokinetic parameters, including elimination half-life, potential for drug-drug interactions, safety profiles, and cost. Each has been shown, when combined with an optimized background regimen (OBR) with at least one other active agent, to achieve virologic suppression in HTE-PWH. Conclusion: In HTE-patients, adding ibalizumab, fostemsavir, and/or lenacapavir to at least one other active agent can lead to virologic suppression in this difficult to treat population. Monotherapy with any of these agents is not recommended and will lead to a high likelihood of drug resistance. Selection of which agent(s) to include with an OBR will depend on other patient factors including concomitant medications, acceptance of formulations (oral vs. subcutaneous vs. intravenous infusion), and potential access (both insurance-based and transportation). Adherence to all agents in the regimen is paramount to successful outcomes.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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