ArticleThe Lancet regional health. Europe2024
Real-world trough concentrations and effectiveness of long-acting cabotegravir and rilpivirine: a multicenter prospective observational study in Switzerland.
Article in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Virologic Failure and Emergent Integrase Strand Transfer Inhibitor Drug Resistance With Long-Acting Cabotegravir for HIV Treatment: A Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- Pooled it
- Safety and efficacy of long-acting cabotegravir/rilpivirine versus standard oral antiretroviral therapy: a systematic review and meta-analysis.The Journal of antimicrobial chemotherapy · 2025Pooled it
- Trial
- Long-Acting Cabotegravir/Rilpivirine Reduces Immune-Activation and -Senescence in People With HIV With CMV Co-Infection.Immunology · 2026Article
- Long-Acting Injectable Antiretroviral Therapies for HIV Treatment and Prevention: Clinical Pharmacology, Recent Advances and Future Opportunities.Journal of clinical pharmacology · 2026Review
- Interactions between long-acting antiretrovirals and opioids: a call for clinical awareness.Clinical microbiology reviews · 2026Review
- External Evaluation of Population Pharmacokinetic Models of Cabotegravir, During Its Oral and Intramuscular Administration in HIV-Infected Patients.CPT: pharmacometrics & systems pharmacology · 2026Observational
- Cabotegravir+rilpivirine long-acting every 2 months in a real-world setting: 24-month outcomes in people with HIV-1.AIDS (London, England) · 2026Article
- Genotyping not required for sustained effectiveness of long-acting cabotegravir plus rilpivirine: evidence from the RELATIVITY cohort.AIDS (London, England) · 2026Article
- Article
- Comparable real-world effectiveness between switches to cabotegravir + rilpivirine long-acting or modern daily oral regimens in the United States: an OPERA cohort study.Journal of the International AIDS Society · 2025Article
- Exploring the Interaction Between Injection Site and Biological Sex on the Real-world Population Pharmacokinetics of Long-acting Cabotegravir and Rilpivirine in People With HIV.Open forum infectious diseases · 2025Article
- Safety, Tolerability, and Metabolic Effects of Long-Acting Cabotegravir and Rilpivirine in HIV Care: A Comprehensive Review.Viruses · 2025Review
- Long-Term Real-World Use of Cabotegravir/Rilpivirine: Adherence and Virological Efficacy over a 44-Month Observation Period.Infectious diseases and therapy · 2025Article
- Influence of patient characteristics and oral lead-in on long-acting cabotegravir and rilpivirine pharmacokinetics and outcomes in people with HIV: a real-world study.Antimicrobial agents and chemotherapy · 2025Article
- Optimizing the Use of Cabotegravir Plus Rilpivirine Long-acting Therapy in HIV Care: Evidence, Implementation, and Unanswered Questions.Open forum infectious diseases · 2025Review
- HIV Viral Suppression With Unintentional Lenacapavir Monotherapy in Adherence-Challenged Patients: A Case Series.Open forum infectious diseases · 2025Article
- Long-Acting Injectable Antiretroviral Therapy for Treatment of Human Immunodeficiency Virus: A Review.Current HIV/AIDS reports · 2025Review
- Transient Viremia Among People with HIV Receiving Injectable Cabotegravir Plus Rilpivirine.AIDS research and human retroviruses · 2025Article
Corrections and comments
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Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The efficacy and tolerability of long-acting cabotegravir and rilpivirine were demonstrated in Phase III trials. However, low concentrations combined with other risk factors have been associated with an increased risk of virologic failure. This study aims to verify whether drug concentrations measured in a real-world setting are consistent with those previously reported. Methods: SHCS-879 is a nationwide observational study within the Swiss HIV Cohort Study for the monitoring of people with HIV (PWH) on long-acting cabotegravir plus rilpivirine. Samples were collected from March 2022 to March 2023. Findings: Overall, 725 samples were obtained from 186 PWH. Our data show a large inter-individual variability in cabotegravir and rilpivirine concentrations, with some individuals exhibiting repeatedly low concentrations. Rilpivirine trough concentrations were consistent with those from Phase III trials, while cabotegravir concentrations were lower. The first concentrations quartile was only slightly above the target of 664 ng/mL. Exploratory statistical analyses found 35% (p < 0·01) lower cabotegravir trough in males compared to females. Overall, 172 PWH (92%) remained suppressed and three experienced virologic failures (1·6%), of those, two had sub-optimal drug exposure. No association was found between low trough levels and detectable viral load. Interpretation: Real-world cabotegravir concentrations are substantially lower than previously reported. However, these concentrations appear sufficient to ensure sustained virological suppression in almost every PWH. These reassuring data challenge the rather conservative thresholds adopted to date, which may raise unnecessary concerns. Yet, our study reveals that some PWH have repeatedly very low drug levels, for reasons that remain to be elucidated. Funding: This work was funded by the Swiss National Science Foundation, grant number N
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