The journal “Science” has designated lenacapavir as the discovery of the year 2024. In two annual injections, this antiretroviral has shown promising results in pre-exposure prophylaxis (PrEP) of HIV infection, even superior to those of Oral PrEP with tenofovir disoproxil fumarate/emtricitabine.
In June 2024, the Gilead Laboratory announced 100% effectiveness in HIV prevention for lenacapavir, an HIV-1 capsid inhibitor administered subcutaneously twice a year, according to the interim results of its double-blind randomized trial. phase 3 (Purpose 1) conducted among more than 5,300 cisgender women (declared gender corresponding to their sex at birth) aged 16 to 25 years in Africa. “No cases of HIV infection were observed among women in the lenacapavir group,” the laboratory noted. In this trial, lenacapavir also showed superior results to tenofovir disoproxil fumarate/emtricitabine (Truvada), an oral PrEP which is administered daily and recommended as first-line treatment. Lenacapavir was generally well tolerated. Faced with these results, Gilead stopped the blinded phase of the trial and offered lenacapavir to all participants.
In November 2024, a similar study funded by Gilead and published in “The New England Journal of Medicine”, recorded only 2 cases of HIV infection in the lenacapavir group, compared to 9 cases of infection in the tenofovir disoproxil group. fumarate/emtricitabine, among more than 3,200 participants with different profiles (cisgender men, transgender women, transgender men and non-binary people in South America, in Asia, Africa and the United States).
And “unprecedented success” for “Science” which made it the discovery of the year 2024. The magazine also sees it as a “fundamental advance in research” because it reveals a new therapeutic target, the HIV capsid protein. “The triumph of this drug therefore raises the exciting prospect that similar capsid inhibitors could combat other viral diseases,” think the authors in “Science”.
Lenacapavir (Sunlenca) is now indicated and managed as a last resort and in combination with other appropriate antiretrovirals, in the treatment of patients with multidrug-resistant HIV-1 infection and for whom currently available antiretroviral treatments do not allow not achieve virological suppression.
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