R&S Academy Orig Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Multiple randomized controlled trials demonstrated IM CAB/RPV effectively maintained HIV viral suppression. Real-world data on CAB/RPV implementation is limited.
Research Question or Hypothesis: The study aimed to apply CAB/RPV trial results in a county population, and to characterize socioeconomic factors affecting CAB/RPV implementation.
Methods: We conducted a pre-post study including adult HIV patients with viral suppression on oral antiretroviral who switched to CAB/RPV. Patients received at least one oral or IM CAB/RPV dose from Riverside University Health System clinics between January 2021 to 2024. We collected data by manual chart review. The primary outcome was the patient proportion of HIV-1 RNA < 50 copies/mL. Secondary outcomes included virologic failure, change in CD4 count, adverse events, and discontinuation. We compared outcomes at baseline versus 6 months post-CAB/RPV switch using McNemar’s test for categorical variables, and paired t-test for continuous variables. We used univariant analysis to evaluate risk factors for the primary outcome; we used a binary logistic regression model to assess risk factors for discontinuation. Statistical analysis utilized SPSS.
Results: 169 patients were included for safety and discontinuation analysis, with 128 patients included for efficacy analysis. 123/128 (96.1%) patients maintained HIV-1 RNA = 50 copies/mL (p=0.727). CD4 count did not significantly change (p=0.115). 4/128 (3.1%) patients had virologic failure. Older age, clinic sites, comorbidities and discontinuation were associated with HIV-1 RNA > 50 copies/mL. 62/169 (36.7%) patients discontinued therapy. Higher California Healthy Place Index, longer commute, and Injection site reaction were significant risk factors for discontinuation. Patients reported more adverse events post-switch (43.6%; p=0.002), highest being injection site reactions (54/169, 32%).
Conclusion: 96.1% county patients maintained HIV viral suppression after CAB/RPV switch, consistent with prior trials. We observed a higher discontinuation rate than prior reports, associated with multiple socioeconomic factors. Resources for social and financial barriers are important for implementing CAB/RPV to ensure treatment success and patient retention.
Presenting Author
Chiao An Chiu PharmD.Riverside University Health System
Authors
Maily Hong PharmD.
Thomas J. Long School of Pharmacy
Marilyn La PharmD.
Kaiser Permanente
Nikki Mulligan PharmD.
Riverside University Health System
Bruce Weng DO
Riverside University Health System
Patrick Wu DO
Kaiser Permanente