Oral lenacapavir + islatravir once weekly as treatment
The combination of oral lenacapavir + oral islatravir is being investigated as a potential treatment.
Lenacapavir interferes with an HIV protein called the capsid. Islatravir interferes with HIV’s ability to use a viral enzyme called reverse transcriptase. Both drugs have long-acting potential.
In a clinical trial, participants who were taking Biktarvy (bictegravir + TAF + FTC) and whose HIV was suppressed were randomly assigned to either receive the combination of lenacapavir + islatravir taken in pill form once weekly or to continue with daily Biktarvy.
Interim data from that study suggests that the combination of lenacapavir 300 mg + islatravir 2 mg was able to keep HIV suppressed in 94% of participants (vs. 92% on Biktarvy).
After 48 weeks, participants who remained virally suppressed on Biktarvy could opt to switch to once-weekly lenacapavir + islatravir. This trial is ongoing.
Analysis of blood samples from participants taken in the first 48 weeks of the study suggest that the combination of lenacapavir + islatravir is potent, as it was able to keep HIV suppressed in a person who entered the study with partial resistance to islatravir (and the drugs 3TC/FTC).
The final stage of studies (phase III) testing the combination of lenacapavir + islatravir is underway.
—Sean R. Hosein
REFERENCES:
- Colson A, Crofoot G, Ruane PJ, et al. Efficacy and safety of weekly islatravir plus lenacapavir in PWH at 24 weeks: A phase II study. Program and abstracts of the 32nd Conference on Retroviruses and Opportunistic Infections, March 9-12, 2025, San Francisco. Abstract 208.
- Vanderveen L, Chang S, Selzer L, et al. Resistance analysis of weekly islatravir plus lenacapavir in people with HIV at 48 weeks. Program and abstracts of the 32nd Conference on Retroviruses and Opportunistic Infections, March 9-12, 2025, San Francisco. Abstract 736.