Section of Infectious Diseases, HIV Program, Mayo Clinic, Rochester, MN, USA.
Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Drugs. 2023 Dec;83(18):1677-1698. doi: 10.1007/s40265-023-01963-9. Epub 2023 Dec 11.
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) provides a critical intervention toward ending the HIV epidemic and protecting people with reasons to utilize PrEP. PrEP options continue to expand as new administration modalities offer the potential to tailor PrEP use for individual success. We have provided the evidence for new and emerging antiretroviral agents for PrEP (cabotegravir, lenacapavir, dapivirine, and broadly neutralizing antibodies), divided into pharmacology, animal model, and human data, accompanied by a summary and suggested place in therapy. Cabotegravir is a US Food and Drug Administration (FDA)-approved intramuscular injection given every 2 months with a strong body of evidence demonstrating efficacy for HIV PrEP, lenacapavir administered subcutaneously every 6 months is currently under investigation for HIV PrEP, dapivirine vaginal ring is an available PrEP option for women in certain areas of Africa, and broadly neutralizing monoclonal antibodies have been challenged in demonstrating efficacy in phase 1-2 study for HIV PrEP to date. Clinical literature for individual agents is discussed with data from major studies summarized in tables. This review provides a detailed overview of recently available and premier candidate PrEP drugs.
人类免疫缺陷病毒(HIV)暴露前预防(PrEP)是终结 HIV 流行和保护有理由使用 PrEP 的人群的重要干预措施。随着新的给药方式为 PrEP 的个体化成功应用提供了潜力,PrEP 的选择不断增加。我们提供了新出现的抗逆转录病毒药物用于 PrEP 的证据(卡替拉韦、拉替拉韦、地匹福林和广泛中和抗体),分为药理学、动物模型和人体数据,并附有摘要和治疗建议。卡替拉韦是一种美国食品和药物管理局(FDA)批准的每 2 个月肌内注射一次的药物,有大量证据表明其对 HIV PrEP 有效,拉替拉韦每 6 个月皮下注射一次,目前正在研究用于 HIV PrEP,地匹福林阴道环是非洲某些地区女性可用的 PrEP 选择,广泛中和单克隆抗体在 HIV PrEP 的 1-2 期研究中证明疗效方面一直面临挑战。本文详细介绍了最近可用的和主要的 PrEP 候选药物,并讨论了各个药物的临床文献,总结在表格中。