Month 12 outcomes of switching to long-acting cabotegravir + rilpivirine with an oral lead-in versus continuing bictegravir/emtricitabine/tenofovir alafenamide in the Phase 3b randomized SOLAR study
Bibliographic record
Abstract
Cabotegravir + rilpivirine (CAB + RPV) dosed every 2 months (Q2M) is the only complete long-acting (LA) regimen for maintaining HIV-1 virologic suppression. In some regions, prescribing information mandates a 4-week oral lead-in (OLI) before initiating CAB + RPV LA. To support clinical decision-making in these areas, we report a pre-specified analysis in adults living with HIV-1 who switched to CAB + RPV LA with an OLI versus continuing daily oral bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) for maintaining virologic suppression in the Phase 3b, randomized, open-label, SOLAR study. In SOLAR, participants with HIV-1 RNA <50 copies/mL were randomized (2:1) to either intramuscular CAB + RPV LA Q2M, with a 1-month optional once-daily OLI of CAB + RPV, or to continue daily oral BIC/FTC/TAF. Month 12 endpoints included virologic response, safety, and patient-reported outcomes. Of 670 participants, 173 (39 %) switched to CAB + RPV LA with OLI, 274 (61 %) switched to CAB + RPV LA starting directly with injections, and 223 (33 %) continued BIC/FTC/TAF. At Month 12, the proportions of participants with HIV-1 RNA ≥50 copies/mL (CAB + RPV LA OLI, 1 % [n = 2/173]; BIC/FTC/TAF, <1 % [n = 1/223]) and HIV-1 RNA <50 copies/mL (CAB + RPV LA OLI, 87 % [n = 151/173]; BIC/FTC/TAF, 93 % [n = 207/223]) were similar between arms. Excluding injection site reactions, adverse events were comparable between arms; however, more participants in the CAB + RPV LA OLI arm had adverse events leading to withdrawal (5 % [n = 8/173] versus <1 % [n = 2/227]). Overall, 87 % (n = 142/163) of participants who switched preferred CAB + RPV LA OLI to BIC/FTC/TAF. Switching to CAB + RPV LA OLI demonstrated comparable efficacy to continuing BIC/FTC/TAF, was well tolerated and preferred by most participants who switched. ClinicalTrials.gov; NCT04542070 (https://clinicaltrials.gov/study/NCT04542070).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".