Guidance for the Interpretation of Long-Acting Cabotegravir and Rilpivirine Concentrations Based on Real-World Therapeutic Drug Monitoring Data and Documented Failures

Paul Thoueille; Matthias Cavassini; Monia Guidi; Thierry Buclin; François R Girardin; Laurent A Decosterd; Catia Marzolini

doi:10.1093/ofid/ofae023

Guidance for the Interpretation of Long-Acting Cabotegravir and Rilpivirine Concentrations Based on Real-World Therapeutic Drug Monitoring Data and Documented Failures

Open Forum Infect Dis. 2024 Jan 16;11(2):ofae023. doi: 10.1093/ofid/ofae023. eCollection 2024 Feb.

Authors

Paul Thoueille¹, Matthias Cavassini², Monia Guidi^{1

3

4}, Thierry Buclin¹, François R Girardin¹, Laurent A Decosterd¹, Catia Marzolini^{1

5

6}

Affiliations

¹ Service and Laboratory of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
³ Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁴ Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.
⁵ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
⁶ Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.

Abstract

The interpretation of long-acting cabotegravir and rilpivirine concentrations is complicated by the lack of consensus on the threshold to consider. Building on real-world therapeutic drug monitoring data and documented virologic failures, this article provides a reappraisal of the existing thresholds and guidance for the interpretation of cabotegravir and rilpivirine concentrations.

Keywords: TDM; cabotegravir; guidance; long-acting; rilpivirine.