1. Ultra-long-acting in-situ forming implants with cabotegravir protect female macaques against rectal SHIV infection.
- Author
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Young, Isabella C., Massud, Ivana, Cottrell, Mackenzie L., Shrivastava, Roopali, Maturavongsadit, Panita, Prasher, Alka, Wong-Sam, Andres, Dinh, Chuong, Edwards, Tiancheng, Mrotz, Victoria, Mitchell, James, Seixas, Josilene Nascimento, Pallerla, Aryani, Thorson, Allison, Schauer, Amanda, Sykes, Craig, De la Cruz, Gabriela, Montgomery, Stephanie A., Kashuba, Angela D. M., and Heneine, Walid
- Subjects
MACAQUES ,PRE-exposure prophylaxis ,INTEGRASE inhibitors - Abstract
Ultra-long-acting delivery platforms for HIV pre-exposure prophylaxis (PrEP) may increase adherence and maximize public health benefit. We report on an injectable, biodegradable, and removable in-situ forming implant (ISFI) that is administered subcutaneously and can release the integrase inhibitor cabotegravir (CAB) above protective benchmarks for more than 6 months. CAB ISFIs are well-tolerated in female mice and female macaques showing no signs of toxicity or chronic inflammation. In macaques, median plasma CAB concentrations exceed established PrEP protection benchmarks within 3 weeks and confer complete protection against repeated rectal SHIV challenges. Implant removal via a small incision in 2 macaques at week 12 results in a 7- to 48-fold decrease in plasma CAB levels within 72 hours. Modeling to translate CAB ISFI dosing suggests that a 3 mL injection would exceed protective benchmarks in humans for over 5 months post administration. Our results support the clinical advancement of CAB ISFIs for ultra-long-acting PrEP in humans. In this study, the authors developed an ultra-long-acting injectable, biodegradable, and removable in-situ forming implant delivering cabotegravir (CAB ISFI). CAB ISFI was well tolerated and protected against multiple rectal SHIV challenges in female macaques. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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