Sherene Min, MD, MPH, the vice president of clinical development at ViiV Healthcare, sat down with Infectious Disease Special Edition to talk about investigational long-acting drugs in the pipeline to prevent and treat HIV. The data were presented at CROI 2025, in San Francisco.
The following was transcribed by Temi.
Sherene Min, MD, MPH (00:13):
So we had a couple of studies that we’re looking at, sort of short-term antiviral effects of two new assets that we have in our pipeline, as well as a study that was looking at a new asset in phase 2b. So for the ones that we’re looking at short-term antivirals, one was a third-generation integrase inhibitor, which we know is the gold standard for HIV treatment. We also had a capsid inhibitor for which we have some precedent in that class. And we saw some good results there with short-term antiviral activity. Then thinking about the longer-term study that we presented on the EMBRACE study that was looking at N6LS, which is a broadly neutralizing antibody, that’s a new class of medicines in the treatment of HIV that ... has good potential for long-acting [treatment] but also has ... possible impacts on immunologic benefit as well. So what we showed in that study was that we maintained viral suppression in people who were already being treated for HIV when they received that broadly neutralizing antibody N6LS with cabotegravir long-acting: our current long-acting medicine.
Can you tell us about long-acting HIV drugs in the pipeline?
Sherene Min, MD, MPH (01:33):
Importantly, I’ll start with VH184, which was the third-generation integrase inhibitor that we presented on. The data that we showed is very much consistent with what we’ve seen with other integrase inhibitors like dolutegravir, as far as what they provide from short-term antiviral effect. What the benefit is of VH184 as a third-generation integrase inhibitor is that it has a different and improved resistance profile versus second-generation integrase inhibitors like dolutegravir, and it has the potential as a long-acting medicine. So those are ... the two main reasons why it’s a third-generation integrase inhibitor. The capsid inhibitor that we presented on [is] VH499. Again, we saw similar antiviral activity to what we would expect for the class. The primary benefits around VH499 versus current HIV treatment and versus the other capsid inhibitor that’s currently on the market: One, [when comparing VH499] versus current HIV treatment, it [VH499] also has the potential for long acting, both for self-administration and for ultra–long-acting with HCP [healthcare provider]-administered medicines. With regards to current capsid inhibitors, the primary benefit around VH499 is that it has a very different drug interaction profile and doesn’t have the same liabilities. So that’s for those two with N6LS, the broadly neutralizing antibody. It’s ... potentially the first bNAb [broadly neutralizing antibody] to move forward as a bNAb in combination with a small molecule … in a two-drug regimen. And we’re really excited that we’ve seen some great potential around its antiviral impact. We’ll hopefully have more data in the future around its potential immunologic benefit. And again, we are moving into a second part of the study that was presented on EMBRACE part 2 that will be looking at N6LS as a potential for an every-six-month regimen.
What are the potential benefits of these drugs?
Sherene Min, MD, MPH (03:43):
So people living with HIV receiving treatment currently … have primarily oral once-daily options. They also have options around receiving treatment every two months with our medicines cabotegravir and then rilpivirine every two months, what we provide with the new medicines that we presented at CROI. First of all, for those people living with HIV who are already on treatment, it provides new options for potentially simplifying their regimens as well as moving them into long-acting opportunities. And so we think that’s where a lot of the benefit lies for those particular group of patients. For people who’ve not been on therapy yet, again, primarily what they are getting right now is oral once-daily and the new medicines that we presented on really provide choices. What we’re going to see moving forward are a lot more choices for people living with HIV who are going on to treatment for the first time, and I think that’s going to really help to revolutionize what HIV treatment looks like in the future.