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HIV Post-Attachment Inhibitor

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HIV Post-Attachment Inhibitor, Ibalizumab, Ibalizumab-UIYK, Trogarzo

  • See Also
  1. Anti-Retroviral Therapy
  • Indications
  1. HIV Infection (part of combination therapy)
    1. Multiresistant HIV in treatment experienced patients
  • Mechanism
  1. Ibalizumab is a recombinant Monoclonal Antibody inhibiting HIV-1 from infecting CD4+ T Cells
  2. Post-Attachment Inhibitor
    1. Binds domain 2 of CD4, inhibiting post-attachment steps needed for HIV entry into host cells
    2. Blocks cell-cell fusion mediated HIV Transmission
  • Dosing
  • Adult
  1. General
    1. Indicated only in multiresistant HIV in treatment experienced patients
    2. Administer in combination with other Antiretrovirals
    3. Inject immediately after reconstituting solution
    4. Arm cephalic veins are preferred IV infusion sites
  2. Load: 2000 mg IV over 30 minutes (and monitor for 1 hour)
  3. Maintenance: 800 mg IV over 30 minutes every 14 days
    1. Monitor for 15 minutes (monitor up to 60 minutes if prior reaction)
    2. Give loading dose instead, if maintenance dose is delayed >3 days (>17 days from last dose)
  • Adverse Effects
  1. Immune Reconstitution Inflammatory Syndrome
  • Safety
  1. Pregnancy
    1. Unknown safety in pregnancy (registry exists)
    2. Increased fetal exposure after 20 weeks
  • Resources
  1. Ibalizumab (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c548ad82-9d1f-4d16-95b6-4e6106badf43