News about Apretude (cabotegravir) 2-month injectable PrEP

[Close2MyBro]

On 3/11/2022 at 8:17 AM, 1stimebare said:

I had an appointment with the doctor this week.  I have been trying to get a prescription for prep for over a year now.  Primary care doctor ignored my first 2 requests.  The physicians assistant finally acted on it when I saw her.  The infectious disease doctor spoke with the kidney doctor who says I can't do either truvada or descovy so only option is the injectable and then they have to closely monitor the liver.  Still waiting for an answer as to cost.  Anyone here on the injectable prep?  If so I would really like to hear your experiences with it.  Please.

There are other options, including putting you on a full HIV regiment instead of just Prep. I have the same kidney concerns and could not use Truvada any longer, which after 5 years started to have a huge negative impact on my kidneys. The nephrologist had my routine changed to a kidney friendly regiment of Edurant and Abacavir/lamivudine. They have little impact on the kidneys but to put a little more work on the liver. The Edurant is not available in generic form but the abacavir/lamivudine is, so cost may be a concern if Edurant is not covered by your insurance. In any event, for me it stopped the kidney decline and my liver tests have been normal for many years now, but I am also not a heavy drinker and don't do any other drugs that would tax my liver. Ask your doctor about other kidney-friendly solutions. If they don't know or aren't willing to try, I'd suggest you find another doctor.

[1stimebare]

 I am on apretude  now and so far tolerating it reasonably well.  More pain from the covid booster than the apretude.   Have not yet put it to the test so to speak but likely will do so in June.

[nekofox]

[think before following links] https://xtramagazine.com/health/injectable-prep-237188?utm_source=squirt&utm_medium=homepop&utm_campaign=featuredarticle

 

To just take a simple injection instead of having to remember to take it orally can help out aplenty, but the only thing that we're still in the middle of seeing is to see if it's just as effective as taking it orally for the medication.  For any that are still on the fence, this is a good article/discussion to look at, but bear in mind that this article is more Canada based for what they talk about in costs and the like, compared to the US having some more leeway for how much PrEP can cost out of pocket with or without insurance.

[rawfuckr]

It's pretty clear Apretude (injectable PrEP) is not as effective as daily oral PrEP (Truvada or Descovy) for people with good adherence. There are clear breakthrough cases in the studies, and  there's no question whatsoever about adherence with injectable. Daily oral PrEP, if subject can adhere to regimen is really 100% protective with extremely rare breakthrough cases.

So the TLDR; if you can take a pill a day efficacy is higher with oral. For the bunch of people of the population when daily adherece is a problem or not desired, injectable still offers very high protection. 

[ellentonboy]

So you are saying we have to go to the doctor every other month for an injection as opposed to having a delivery man come to my door to drop off my meds and controlled substances. My doctor requires me to come twice yearly to make sure I have behaved,,,,,,,,I will stick with the delivery guy.

[hntnhole]

1 hour ago, ellentonboy said:

My doctor requires me to come twice yearly

Mine wanted me to come quarterly, but I told him it would be monthly for testing.  The way I see it, the quicker some bug can be detected and treated, the better.  When I explained my thought process, he objected, I insisted, and that was that.  

[ellentonboy]

14 hours ago, hntnhole said:

Mine wanted me to come quarterly, but I told him it would be monthly for testing.  The way I see it, the quicker some bug can be detected and treated, the better.  When I explained my thought process, he objected, I insisted, and that was that.  

I find your doctor's response surprising.  I switched physician's because the previous one always wanted to run some new test, send me to some specialist for a condition that he THOUGHT I might have, it was like "doctor-a-go-go".  I understand your concern about being seen monthly, that's wise.  You would think he would want to bill your insurance, as most guys try as much as possible to avoid going to see their doctor.  I finally changed because my long time doctor would no longer be my "primary care physician", nor would he write controlled substances, in my case sleeping pills.  So that meant I needed to see three doctors now, instead of one.  He did make an announcement and he did give everyone ample time to find a PCP and someone to write controlled substances.  But WHY do I need three doctors, when he just continue to follow the same course and treat everything himself.  Why?  MONEY.  He became part of corporation.  I really think I will start a thread on here because after being a patient of a doctor for so many years, and then finding he had a change in "Business Model", I was furious.  Now I have an Infectious Disease Specialist who is about to turn 68 and I fear he may retire any day.  

I am glad there are posters on here who want to have their health monitored.  Frankly, and I know this idea is not popular, but I cannot wrap my head around "bug chasing" or failing to treat an illness and let it just run it's course, so to speak. 

I hope you remain healthy........it seems most gay men I meet have at least one on-going condition, and that is a shame.

[hntnhole]

11 minutes ago, ellentonboy said:

I find your doctor's response surprising

So do I.  He's older, very close to retirement, and Dr. Methuselah is about to be retired from association with me sooner than he thinks.  I'm not one to worship at the High Holy Doctor's Shrine.  I ask questions and expect answers.  I mean, 'supported by research' answers, not 'well, I've been doing this for many years, and I think X instead of Y'.  My kid sister is coming for a visit next month, and that's great.  As soon as that's over though*, I'll be turning my attention to finding another internist.  

I couldn't agree more, that the level of care has suffered in favor of the level of Corporate Grasping.  I'm not sure how to counter that widening gap, other than to go talk to them, get a feel for who they really 'service' and make my best guess.  

I am healthy, thanks.  I can't even remember when I last had so much as a cold, never came down with covid (knocking), have taken all the precautions, and proceeding with caution.  Of course, I've picked up breeding-bugs regularly, but they get treated quickly and that's just the price of doing business.  As to all the bug chasing commentary on here, I can't help but wonder how many actually have that kind of devotion to their Lusts, or the courage to actually live The Life.  Popularity on a website is one thing; living one's best life is another. 

I hope you're healthy too, and thanks for the well wishes.  

*she and I have always been close, she's always been completely supportive, but I don't think she knows quite how gay I actually am.  I've been hammering at getting the slingroom taken down, put away, getting other things ready, blah blah blah.  

[1stimebare]

Had my most recent injection and blood work last week.  Still negative and still the only patient at that office getting apretude.

[bridgeHIV]

There's a new study for twice yearly injectable PrEP. The new med is called Lenacapavir and it just got FDA approval for treatment use in the US. The injection is an infusion in the abdomen where the drug releases over 6 months. The study goal is to answer if Lenacapavir is as good as or better than daily Truvada. 

 

FDA approval for treatment in USA: [think before following links] https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-approves-gileads-long-acting-hiv-drug-sunlenca-2022-12-22/

Information on study: [think before following links] https://www.purposestudies.com/purpose2/

[bridgeHIV]

Super late to the party but if you're interested in trying Apretude, there's a study that works with insurance (not Kaiser) or not if you don't have it, to look at people's experience receiving PrEP. It's been difficult to navigate different insurance types ie Kaiser, Blue Shield, so this study might be a better fit for folks receiving MediCal or uninsured. 

Apretude Study in San Francisco, CA: [think before following links] https://helpfighthiv.org/pillar/

Apretude Study in general: [think before following links] https://clinicaltrials.gov/ct2/show/NCT05374525

[PG1961Canada]

On 5/8/2022 at 9:29 AM, atyl7u said:

I just started on Descovy and the PrEP clinic didn't mention anything about injectable PrEP. Anyone know if it's authorized for use in Canada?

I'm going to see my guy next week in Hamilton and plan to ask him what is happening in Canada w.r.t. injections.  We are usually a little slower than the USA to get approvals through our system.  But, I'm sure it will happen here as well.  At one point, Truvada was the only PrEP option... and now, Descovy is on the list.  I'm hopeful.

[Vacuumtoob]

Just had my first Apretude injection... so far no issues. Manufacturer offered to pay for a large part, thanks to my very helpful ID doctor and nurse. IMHO worth the visits for the injectable.  

[1000GUYS]

cant wait to have it in my country

[tallslenderguy]

"FDA Approves Apretude: First Injectable Option for HIV Pre-Exposure Prophylaxis"

"Key takeaways:

Apretude (cabotegravir) is a long-acting injectable medication that can prevent HIV contraction and is targeted at people at high risk for exposure.

Apretude is typically injected into the muscles of your buttocks every 2 months by a healthcare professional.

There are ways to save on Apretude. If you’re eligible, a manufacturer savings card can help you access Apretude for as little as $0 per injection. A patient assistance program is also available."

[think before following links] https://www.goodrx.com/apretude/fda-approves-apretude

 

"WHO recommends long-acting cabotegravir for HIV prevention"

[think before following links] https://www.who.int/news/item/28-07-2022-who-recommends-long-acting-cabotegravir-for-hiv-prevention