Men Are Not Macaques and Other Lessons From Long-Acting PrEP Study

Imagine seeing a patient every eight weeks for a few quick injections into the buttocks that could prevent HIV between appointments.

That’s the promise of the ÉCLAIR trial of the investigational integrase strand transfer inhibitor cabotegravir, which had its phase-2 results unveiled at CROI 2016 in February. ÉCLAIR was one of two trials of long-acting injectable HIV-prevention programs presented at the conference.

“Cabotegravir in oral and long-acting injections were well tolerated,” said Martin Markowitz, M.D., the trial’s primary investigator, in his presentation at CROI. “We feel this does permit continued development of cabotegravir for PrEP [pre-exposure prophylaxis].”

Designing Long-Acting Agents

This study was a phase-2 trial — that is, it wasn’t designed to figure out how effective the drug was in preventing HIV acquisition in the mostly gay and bisexual men who participated in the trial. It had more fundamental things to figure out first: whether it was safe for human use, what dose would maintain effectiveness between doctors’ visits and whether men liked the approach enough to take it.

On all counts, the answer appears to be, “Yes.”

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