Antibody-based strategies in HIV therapy.
Int J Antimicrob Agents. 2020 Oct 09;:106186
Authors: Kufel WD
Antibody-based strategies have been introduced for a number of disease states, but represent a novel approach in HIV management. Ibalizumab and leronlimab are monoclonal antibodies with unique mechanisms as a CD4-directed post-attachment inhibitor and C-C chemokine receptor type 5-directed inhibitor, respectively. These antibody-based strategies are generally well-tolerated, have a favorable pharmacokinetic profile allowing for less frequent dosing, and have a high barrier to resistance. Ibalizumab is currently approved by the United States Food and Drug Administration (US FDA) for management of multidrug-resistant (MDR) HIV infection in patients who are failing their current regimens. Clinical data demonstrated impressive antiretroviral activity with ibalizumab among a complex HIV population in combination an optimized background regimen, where limited therapeutic options exist. Leronlimab has not been granted approval by the US FDA, but has been designated fast-track status. Leronlimab is being studied as a maintenance monotherapy agent in virologically suppressed patients as well as for treatment of MDR HIV infection in patients who are failing their current regimens. Currently available data in both of these potential areas appears promising for leronlimab. The mechanism of action, pharmacokinetic profile, efficacy, and safety of these novel antibody-based strategies present an advance in the management of HIV. Future studies and postmarketing experience will further determine longer-term clinical efficacy, safety, and resistance data for ibalizumab and leronlimab.
PMID: 33045349 [PubMed - as supplied by publisher]