Continuous infusion of T-20 in multidrug resistant patient with intolerance of s.c. injections

A poster from NW Neijzen and colleagues from UMC Utrecht reported on using continuous infusion of enfuvirtide (T-20) using a tunnelled central venous catheter in a 70 year old patient with multidrug HIV resistance and intolerance to subcutaneous injections.

T-20 was prepared in an elastomeric pump (5 mL.hr, 275 mL, 180 mg T-20 over 24 hours). Before and after switching formulations multiple plasma samples were used to determine individual pharmacokinetics.

The formulation was stable at 2-8° for seven days and for 24 hours at room temperature, and continuous infusion resulted in therapeutic plasma concentrations that were approximately four times higher that previous Ctrough using s.c. administration (3529 vs 755 ng/mL; the proposed MEC for T-20 is 2100 ng/mL).

During two months of follow-up the patient remained clinically stable, with an undetectable viral load and increasing CD4 count.

Ref: Neijzen RW et al. Continuous intravenous infusion of enfuvirtide in an out-patient clinic with a multiresistant HIV strain and severe injections site reactions. 14th International Workshop on Clinical Pharmacology. 22-24 April 2013. Amsterdam. Poster abstract P_09.