Are long-acting HIV medications the key to better adherence?

By Mathew Rodriguez

If you haven’t heard of “GSK744,” it has the potential to become the first HIV medication that need only be taken once a month.

GSK744 (short for S/GSK1265744) is an investigational integrase inhibitor; it is a long-acting version of the U.S. FDA-approved HIV medication Tivicay (dolutegravir). What’s the big difference? Well, this new drug is being developed specifically to have a very long “half-life,” which refers to the time it takes to break down inside the body — GSK744 takes a lot longer to break down in the body than currently approved HIV meds. As a result, early studies suggest that — although the drug will need to be injected by a clinician — it may only need to be taken once every 30 days, or even longer.

The idea is that therapies like GSK744 could address adherence concerns because the regimen is only once-a-month instead of once-a-day, and the treatment would be administered and directly observed by a health care professional. (It’s also being investigated for possible use in pre-exposure prophylaxis for the same reason.)

That said, when it comes to adherence, what works for some will not work for others. Taking a daily pill gives some people the freedom to make their own travel schedules, to take their medication on their own terms and in comfortable settings. Some people won’t want to go to their doctor (and pay to see the doctor!) every month to get their medication, while some people may struggle with taking a daily reminder of their HIV status and might welcome a less-frequent dose.

Research on this drug — as well as other ones like it — is still in its early stages, and even if further studies prove successful, it will likely be years before any long-acting antiretrovirals are approved by the U.S. Food and Drug Administration. But still, excitement about long-acting regimens is on the rise. What do you think? Would you take advantage of long-acting injectables? Or do you prefer to take your medications on your own time in pill form? What would make you switch?



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