Question
My clinic has offered me injectable ART – is this as good as pills?
23 December 2022. Related: Access to treatment, All topics.
Hi. I have been offered a swap of my meds to Cabenuva I believe this is an injection?
Does this work as well as tablets? I understand there are more visits required but I am concerned it won’t work which is scary.
I can’t find much about people’s experiences.
Answer
Hi there
Thanks for your question and for letting us post this online.
You are right that Cabenuva is given by injection – with two injections given every two months. Also, that as a new treatment there is less experience in real life, other than from the main research studies.
Cabenuva was approved in the USA and Europe in 2021 because injections work as well as oral pills in treating HIV. It was also similar in terms of the risk of side effects – so long as you don’t mind injections.
Using this injectable ART involves six clinic visits every year. These have to be on schedule though so you can’t miss visits, you need to take oral pills until you can attend.
One concern – and it only affected a small number of people – is that treatment did fail some people, even when they took the injections exactly on time. The biggest concern is that drug resistance developed against both drugs and limited the use of both integrase inhibitors and NNRTIs afterwards.
These cases have not been fully explained yet but researchers are trying to find out why. This is an important concern to talk about with your doctor.
You also asked about people’s experience.
Nearly everyone in the research studies preferred the injections to taking pills, but it is important to remember that these people actively chose to join the study because they already did not like taking oral pills.
This makes it a very individual decision to use injections rather than pills.
For someone who has difficulty with daily pills, the benefits of changing to six injections a year might balance the small risk of treatment not working. The risk is about 1 in 60 over two years.
For someone who is doing well with pills, there isn’t any reason to change. This is especially if you are already good with adherence. On this point, oral meds are technically better,
Is there a reason why your clinic offered you the injections?
Please talk through the advantages and disadvantages before deciding what is right for you.
Information about using inectable ART is sumarrised by the Britich HIV Association *BHIVA) here:
https://www.bhiva.org/file/62012a06e2920/interim-BHIVA-guidance-on-LA-CAB-RPV-for-antiretroviral-therapy.pdf (PDF)
i-Base information here also links to more detailed sources.
https://i-base.info/guides/15361
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