A new combination pill containing bictegravir and lenacapavir shows promise for people with HIV who require complex regimens. The phase three ARTISTRY 1 study found it performed as well as existing multi-pill options. Experts note its impact in South Africa will likely remain limited.
The ARTISTRY 1 study, published in The Lancet in February, involved 557 adults who had been on HIV treatment for an average of 28 years. Participants switched to the bictegravir-lenacapavir pill or stayed on their existing regimens. The new pill proved non-inferior, with no drug resistance observed and higher treatment satisfaction reported.
Chloe Orkin, the study’s principal investigator, highlighted an unmet need for those on complex regimens often due to resistance or intolerance. Side effects remained similar across groups, with no drug-related deaths.
Local experts Francois Venter and Graeme Meintjes described the findings as a breakthrough for a small group of patients, mostly in the private sector. They noted that dolutegravir-based regimens like TLD continue to serve most people in South Africa effectively.
The results also support calls to move away from first-, second- and third-line terminology in favour of initial and subsequent regimens, given the potency of current treatments.
