1 Recommendations

1 Recommendations

1.1 Cabotegravir with rilpivirine is recommended, within its marketing authorisation, as an option for treating HIV‑1 infection in adults:

  • with virological suppression (HIV‑1 RNA fewer than 50 copies/ml) on a stable antiretroviral regimen and

  • without any evidence of viral resistance to, and no previous virological failure with, any non-nucleoside reverse transcriptase inhibitors or integrase inhibitors.

    It is recommended only if the company provides it according to the commercial arrangement.

Why the committee made these recommendations

Current treatment for HIV‑1 is antiretroviral regimens taken as tablets (orally) each day. The aim is to keep the number of virus particles in the blood (the viral load) so low that it cannot be detected, so that the virus cannot be transmitted between people. Cabotegravir with rilpivirine is the first long-acting antiretroviral injection available for HIV‑1.

Clinical trial results show that cabotegravir with rilpivirine is as effective as oral antiretrovirals at keeping the viral load lower than 50 copies/ml of blood. It is unclear whether there would be a difference in adherence between long-acting injections and daily oral tablets. The most likely cost-effectiveness estimate is likely to be within what NICE normally considers an acceptable use of NHS resources. So, cabotegravir with rilpivirine is recommended.

  • National Institute for Health and Care Excellence (NICE)