Susan Swindells, MBBS, on the ATLAS Trial

The 48-week results of the ATLAS study indicate that the regimen of monthly intramuscular injections of cabotegravir/rilpivirine is non-inferior to the continuation of 3-drug oral antiretroviral (ART) therapy in adults with virologically suppressed HIV-1 infections.

The findings of the study were presented in an oral abstract presentation at the Annual Conference on Retroviruses and Opportunistic Infections (CROI 2019). Contagion® spoke exclusively to Susan Swindells, MBBS, professor in the Department of Internal Medicine at the University of Nebraska Medical Center, who presented the findings of the study at the meeting (see video).

Interview Transcript: (modified slightly for readability)

Contagion^®: Can you summarize the ATLAS trial?

Dr. Swindells: "So, my trial is called ATLAS, and it's a phase 3 study of a different way of taking anti-HIV medicines by injection as opposed to daily oral therapy. There are 2 drugs involved in the study, one’s an inhibitor called cabotegravir and one's a non-nucleoside reverse transcriptase inhibitor called rilpivirine. They're both formulated to make long-acting injections possible up to a month apart, perhaps, in the future even less frequently, but in this study, they were given to patients a month apart.

So, the study enrolled patients on conventional oral therapy that had virologic suppression, they were randomized to continue their daily oral therapy or to go on to monthly injections of cabotegravir/rilpivirine. At 48 weeks we looked at the results and they were very similar in terms of the number of patients in each arm that had detectable virus — very small numbers in each arm – more than 90% suppressed in both arms. It was a non-inferiority designed so non-inferiority was met and there were 3 virologic failures in the investigational arm with the injections."

For more information on cabotegravir/rilpivirine studies presented at CROI 2019, check out our coverage on the ATLAS and FLAIR trials.