Heavily Treatment-Experienced HIV-1 Patients | HCP Site

Despite Advances in ARVs, HTE Patients May Struggle to Maintain Viral Suppression and Have Limited Treatment Options^1,2

Over the past 3 decades, antiretroviral treatment for HIV has improved considerably with the approval of additional classes of treatment. However, there are still people with HIV who struggle to achieve viral suppression due to multiple factors.^1,3

The FDA considers patients to be HTE if they⁴:

Have resistance to multiple drugs and drug classes

Are unable to construct a regimen that suppresses HIV RNA to below assay quantification limits

For HTE patients, the journey to viral suppression is challenging and nonlinear. Clinical and logistical challenges may contribute to treatment failures. In the US alone, a large multicenter study from 2000 to 2017 found that the median number of prior ARVs taken by HTE patients with limited treatment options was 11.^2,3,5,^*

Agents with novel mechanisms of action could expand treatment options for HTE patients^1,5

INDICATION

SUNLENCA®, in combination with other antiretroviral(s), is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in heavily treatment-experienced adults with multidrug resistant HIV-1 whose current antiretroviral regimen is failing due to resistance, intolerance, or safety considerations.

Important Safety Information

Contraindications

Coadministration: Concomitant administration of SUNLENCA is contraindicated with strong CYP3A inducers.

Warnings and precautions

Immune reconstitution syndrome, including the occurrence of autoimmune disorders with variable time to onset, has been reported in patients treated with combination antiretroviral (ARV) therapy.

INDICATION

SUNLENCA®, in combination with other antiretroviral(s), is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in heavily treatment-experienced adults with multidrug resistant HIV-1 whose current antiretroviral regimen is failing due to resistance, intolerance, or safety considerations.

Tap for Important Safety Information

Important Safety Information

Contraindications

Coadministration: Concomitant administration of SUNLENCA is contraindicated with strong CYP3A inducers.

Warnings and precautions

Immune reconstitution syndrome, including the occurrence of autoimmune disorders with variable time to onset, has been reported in patients treated with combination antiretroviral (ARV) therapy.

INDICATION

SUNLENCA®, in combination with other antiretroviral(s), is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in heavily treatment-experienced adults with multidrug resistant HIV-1 whose current antiretroviral regimen is failing due to resistance, intolerance, or safety considerations.

Long-acting properties and potential associated risks with SUNLENCA: Residual concentrations of SUNLENCA may remain in the systemic circulation of patients for up to 12 months or longer. SUNLENCA may increase exposure, and potential risk of adverse reactions, to drugs primarily metabolized by CYP3A initiated within 9 months after last injection. Counsel patients regarding the dosing schedule because nonadherence could lead to loss of virologic response and development of resistance. If virologic failure occurs, switch to an alternative regimen if possible. If discontinuing SUNLENCA, begin alternate suppressive ARV regimen within 28 weeks from last injection.
Injection site reactions may occur, and nodules and indurations may be persistent. Improper administration (intradermal injection) has been associated with serious injection site reactions.

Adverse reactions

Most common adverse reactions (incidence ≥3%, all grades) are injection site reactions (65%) and nausea (4%).

Drug interactions

Prescribing information: Consult the full prescribing information for SUNLENCA for more information on Contraindications, Warnings, and potentially significant drug interactions, including clinical comments.
Enzymes/transporters: Drugs that are strong or moderate inducers of CYP3A may significantly decrease the concentration of SUNLENCA. Drugs that strongly inhibit CYP3A, P-gp, and UGT1A1 together may significantly increase the concentration of SUNLENCA. SUNLENCA may increase the exposure of drugs primarily metabolized by CYP3A, when initiated within 9 months after the last injection of SUNLENCA, which may increase the potential risk of adverse reactions.

Dosage and administration

Dosage: Initiation with 1 of 2 options, followed by maintenance injection dosing once every 6 months. Tablets may be taken with or without food.
- Initiation Option 1: Day 1: 927 mg by subcutaneous injection and 600 mg orally (2 x 300-mg tablets). Day 2: 600 mg orally (2 x 300-mg tablets).
- Initiation Option 2: Day 1: 600 mg orally (2 x 300-mg tablets). Day 2: 600 mg orally (2 x 300-mg tablets). Day 8: 300 mg orally (1 x 300-mg tablet). Day 15: 927 mg by subcutaneous injection.
- Maintenance: 927 mg by subcutaneous injection every 26 weeks +/- 2 weeks from date of last injection.
Planned missed injections: If scheduled injection is to be missed by more than 2 weeks, SUNLENCA tablets may be used for oral bridging for up to 6 months until injections resume. Dosage is 300 mg orally (1 x 300-mg tablet) every 7 days.
Unplanned missed injections: During the maintenance period, if more than 28 weeks have elapsed since the last injection and tablets have not been taken for oral bridging, restart the initiation dosage regimen from Day 1, using Option 1 or Option 2, if clinically appropriate.

Pregnancy and lactation

Pregnancy: There is insufficient human data on the use of SUNLENCA during pregnancy. An Antiretroviral Pregnancy Registry (APR) has been established.
Lactation: Individuals with HIV-1 infection should be informed of the potential risks of breastfeeding.

Please see full Prescribing Information for SUNLENCA.