lenacapavir (Sunlenca, Yeztugio)
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Indications
- multi-drug resistant HIV1 infection
- combined with other antiretroviral agents
- HIV1 pre-exposure prophylaxis (investigational)[2][3]*
* incidence of HIV1 infection in cisgender women 0/100 person-years[3][4]
Dosage
- given both orally & by subcutaneous injection (SQ) every 6 months
- start: 2 subcutaneous injections 927 mg & 2 days of overlapping oral daily pills (2 300-mg tablets daily)
- 2 SQ injections every 6 months, within 14 days before or after the target date
- longer delays should be bridged with 300 mg of oral lenacapavir weekly
- when reinitiating lenacapavir injections after a delay > 14 days without bridging, the 2-day oral overlap is recommended (see above)
* SQ injections administered in the abdomen, anterior thigh, upper gluteus, or posterior upper arm
Mechanism of action
- HIV1 capsid inhibitor
Notes
- estimated cost $42,250 in the first year of treatment
- therafter $39,000 annually in the subsequent years
More general terms
References
- ↑ Hick L FDA Approves First-in-Class Drug for HIV Medscape. December 22, 2022 https://www.medscape.com/viewarticle/986049
- ↑ 2.0 2.1 NEJM Journal Watch. July 30, 2024 2024 International AIDS Conference (results of the PURPOSE-1 study)
- ↑ 3.0 3.1 3.2 Bekker L-G et al. Twice-yearly lenacapavir or daily F/TAF for HIV prevention in cisgender women. N Engl J Med 2024 Jul 24; [e-pub]. PMID: https://pubmed.ncbi.nlm.nih.gov/39046157 https://www.nejm.org/doi/10.1056/NEJMoa2407001
Walensky RP, Baden LR. The real PURPOSE of PrEP - effectiveness, not efficacy. N Engl J Med 2024 Jul 24; [e-pub]. PMID: https://pubmed.ncbi.nlm.nih.gov/39046168 https://www.nejm.org/doi/10.1056/NEJMe2408591 - ↑ 4.0 4.1 Yamey G, Machingaidze S. Lenacapavir: a giant step forward in HIV prevention-but a missed opportunity for achieving equity and access. BMJ. 2024 Oct 14;387:q2254. doi:http://dx.doi.org/ 10.1136/bmj.q2254. PMID: https://pubmed.ncbi.nlm.nih.gov/39401824