The HIV division of GSK is counting on long-acting cabotegravir to grow. At least one team of analysts says that evidence from the real world is starting to back up the company’s claim that it has the winning recipe.
The cabotegravir brand, which presently includes Cabenuva therapy and Apretude for PrEP, may achieve peak sales of around £3 billion in 2030, according to estimates made by ODDO BHF analysts on Friday. GSK’s whole HIV business could generate about £7 billion in revenue by 2026.
After speaking with HIV specialist Christine Katlama in France, the ODDO team received confirmation of their prediction. The lesson? Long-acting HIV medicines enable a considerable increase in quality of life and greater treatment adherence. They are “true game-changers for patients,” the researchers noted. Analysts at ODDO say that GSK’s cabotegravir is the best on the market and that it is unlikely to face any serious competition in the near future.
Global sales of GSK’s HIV medications
Global sales of GSK’s HIV medications were £4.8 billion in 2016. British pharma says that the peak market value of medicines based on cabotegravir will be more than £2 billion.
Lenacapavir from Gilead Sciences is the only significant rival in the long-acting market. Currently, the highest dosing interval for cabotegravir is two months, but the maximum dosing interval for the capsid inhibitor is six months. Just like cabotegravir, lenacapavir needs to work with another antiretroviral drug, but Gilead doesn’t yet have a long-acting partner.
Lenacapavir was initially combined with the possibly long-acting islatravir from Merck & Co. Still, a recent failure in a clinical trial has forced Merck to rethink the right drug dosage strength. Starting in September, a new phase 3 program will help them do this.
However, switching from daily medications to an injection administered once every two months won’t be a simple task. Cabenuva’s antiviral potency and dose regimen are still under scrutiny.
Data from GSK’s HIV-focused clinical trials ViiV Healthcare and academics are now giving more answers to these questions, and the evidence is currently in favor of cabotegravir.
After 3.4 months later
Researchers examined electronic health information from a database called Observational Pharmaco-Epidemiology Research and Analysis for a presentation at IDWeek 2022. (OPERA). US patients with 99% viremia after the initial Cabenuva injection were retested 3.4 months later. Even after 3.4 months, it still kills the virus.
At the time of the first prescription, 91% of patients with a median viral load of 16,400 copies/mL and more than 200 copies/mL had less than 200 copies/mL. The name for this is “virologic suppression.”
Despite collecting patient data for a short time, the researchers found that Cabenuva helps virology-repressed patients.
The U.S. gave Cabenuva its blessing in January 2021. It “shows how much passion there is surrounding Cabenuva” that real-world studies have already been conducted, according to ViiV’s head of R& D, Kimberly Smith, M.D., in an interview with Fierce Pharma.
Although Cabenuva’s clinical trials produced compelling evidence, market observers were nevertheless curious as to whether the results would hold true in practice. According to the data so far, “people are doing well, they’re tolerant, and they’re pleased,” Smith said. “We saw the same thing that we saw in our crucial trials.”
In contrast to needles, doctors who treat HIV typically recommend tablets. According to findings presented at IDWeek 2022, 79% of clinicians who participated in a separate observational study of healthcare professionals across 24 U.S. sites said they felt “very” or “very” positively about prescribing Cabenuva. About 87% of responders stated that injection visits, including waiting time, took less than 45 minutes. Overall, 75% of those who answered thought that at least 25% of their current patients were good candidates for Cabenuva.