Multicentre service evaluation of injectable cabotegravir and rilpivirine delivery and outcomes across 12 <scp>UK</scp> clinics (<scp>SHARE LAI</scp>‐net)
Kyle Ring, Melanie Smuk, Moses Shongwe, Leroy Okonta, Nicola Mackie, Sara Ayres, Tristan Barber, Jane Akodu, Filippo Maria Ferro, Daniella Chilton, Eliot Hurn, Bhavna Halai, Will Barchi, Asim Ali, Sandra Darko, Gemma White, Emily Clarke, F. CLARK, Bazga Ali, Joseph Arumainayagam, Gaynor Quinn, Marta Boffito, Ruth Byrne, Nadia Naous, Suki Leung, Athavan Umaipalan, Brian Thornton, David Bayliss, Catherine McLoughlin, Jonathan D. Foster, Laura Waters, Chloe Orkin
Abstract
INTRODUCTION: Long-acting injectable cabotegravir + rilpivirine (CAB + RPV LAI) was approved for use in virally suppressed adults in the England and Wales national health service in November 2021. We describe a service evaluation of delivery processes and outcomes in 12 clinics. METHODS: Centres populated a database using information from local policies and clinical records. Services were asked to describe approval processes, clinic pathways, and adherence to national guidelines. Additional data were collected on reasons for regimen choice, treatment discontinuations, and management of viraemia. RESULTS: In total, 518 adults from 12 clinics were approved for CAB + RPV LAI between February 2022 and December 2023. Of the 518 people approved for CAB + RPV LAI, 423 received at least one injection. Median duration on CAB + RPV was 7.5 months (interquartile range 3.7-11.3). In total, 97% of injections were administered within the ±7-day window. Virological failure occurred in 0.7%, and 6% discontinued CAB + RPV. CONCLUSION: In this large UK-based cohort, robust approval processes and clinic protocols facilitated on-time injections and low rates of both discontinuation and virological failure.