Apretude (cabotegravir): PrEP Made Easier

On May 10, 2024, injectable PrEP (pre-exposure prophylaxis) was approved for use in Canada for the prevention of HIV. Apretude (cabotegravir) represents a significant advancement in HIV prevention, offering a promising alternative to daily oral PrEP medications.

What is Apretude?

Apretude is an injectable form of cabotegravir, a medication specifically designed to prevent HIV infection. Unlike traditional PrEP medications, which require daily oral intake, Apretude is administered via injection in the buttock every two months. This long-acting injectable option provides a convenient and effective method for individuals at risk of HIV, reducing the burden associated with taking pills daily.

The Benefits of Apretude

1. Improved Adherence: One of the advantages of Apretude is its dosing schedule. With only six injections per year (after the initial dosing), it is much easier for individuals to adhere to their HIV prevention regimen, compared to the daily pill burden of traditional PrEP.

2. Efficacy: Clinical trials have demonstrated that Apretude is highly effective in preventing HIV infection. In studies, it has shown superior efficacy compared to daily oral PrEP, providing robust protection against the virus. This may be attributed to the reduced adherence requirements associated with Apretude.

3. Convenience: For many people, remembering to take a daily pill can be challenging. Apretude's bi-monthly injections offer a convenient alternative, making it easier for individuals to maintain consistent protection.

4. Choice: Introducing an alternative to daily oral PrEP empowers patients by providing them with options and enhancing their autonomy in managing their HIV prevention regimen.

Dosing schedule

Based on individual needs, doctors may begin treatment with daily 30mg tablets of cabotegravir for a month before transitioning to the injectable form of Apretude to assess tolerance. Alternatively, the doctor may decide to start directly with the Apretude injection, bypassing the need for oral pills.

Initially, patients are given Apretude once every month for the first two months, after which it is administered bi-monthly. Consult with your physician today to discuss if Apretude is the right choice for you.

Is Apretude covered by insurance companies and OHIP?

VIIV Healthcare, the manufacturer of Apretude, is currently in negotiations with private insurance companies and the Ontario Health Plan Committee (ODB, Ontario’s public health plan) to establish pricing for Apretude, aiming to secure comprehensive coverage for this medication. However, this process may extend over a period of up to one year.

Side effects and disadvantages

Apretude, like any medication, can come with its own share of side effects. Common ones include headaches, diarrhea, and hot flashes. Additionally, individuals may experience pain, redness, and swelling at the injection site.

One drawback of Apretude is its mode of administration. Unlike oral medications that can be taken at home, Apretude requires administration by a nurse or doctor. This reliance on healthcare professionals for administration can pose challenges, especially considering the growing healthcare demands in Canada, which may lead to difficulty scheduling timely appointments with healthcare providers.

Moreover, for individuals with needle phobia, the requirement for injection can be particularly daunting, potentially favoring the use of daily oral pills instead. It's essential to discuss these considerations with your healthcare provider to determine the most suitable HIV prevention option for you.

Coming Soon!

The approval of Apretude marks a significant milestone in HIV prevention, offering a new, convenient, and effective option for individuals at risk. By reducing the frequency of dosing and enhancing adherence, Apretude empowers patients with greater autonomy and flexibility in their HIV prevention regimen. Stay tuned for the availability of Apretude at MedsExpert Clinic & pharmacy or speak to one of our healthcare providers today!

Sources:

• Catie-Health Canada approves Apretude, the first long-acting injectable for HIV prevention (2024)

• ViiV Healthcare announces Health Canada approval for Apretude (Cabotegravir tablets and extended release injectible suspension) for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV (2024)

• High Interest in Long-acting Injectable Pre-exposure Prophylaxis (LAI-PrEP) for HIV Prevention Among Men Who Have Sex With Men (MSM): Result From A Nationwide Survey in Malaysia. Journal of Community Health (2023)

• Determinants of Pre-exposure Prophylaxis (PrEP) Implementation in Transgender Populations: A Qualitative Scoping Review (2022)

• Gay, Bisexual, and Other Men Who Have Sex With Men Who Are Not on Oral PrEP may be Less Interested in Available Injectable Products than in Oral PrEP: Examining Individual-Level Determinants of Interest and Barriers Across Products (2022)