Real‐world use and effectiveness of fostemsavir in a US clinical setting: Insights from Trio Health HIV Research Network
7 affiliations
- 1Analytics Trio Health Louisville Colorado USA
- 2Epidemiology and Real World Evidence Viiv Healthcare Durham North Carolina USA
- 3Infectious Disease Midway Immunology and Research Center Fort Pierce Florida USA
- 4Care Resource Miami Florida USA
- 5School of Medicine at the University of Pennsylvania Philadelphia Fight Community Health Centers Philadelphia Pennsylvania USA
- 6Ruth M. Rothstein CORE Center Rush University Medical Center Chicago Illinois USA
- 7Medical Affairs and Education Labcorp Burlington North Carolina USA
Abstract
Objective: To describe real‐world patterns of use, virologic and immunologic outcomes and treatment persistence among people with HIV (PWH) initiating fostemsavir (FTR) in a diverse US cohort.
Design: Retrospective cohort study of adults receiving FTR in clinical practice, stratified by baseline viral suppression status.
Methods: Adults with ≥1 FTR prescription between July 2020 and August 2023 were included and followed for 12 months. Individuals with trial participation were excluded. Outcomes included virologic suppression (<50 and <200 copies/mL), confirmed virologic failure, viral blips, CD4 changes and immunologic recovery among those with baseline CD4 <350 cells/mm3. Persistence and adherence were assessed using dispensing data and proportion of days covered.
Results: Seventy‐seven PWH were included (60% viremic, 40% suppressed). Multidrug resistance was observed in a subset (31%). At 12 months, most individuals remained on FTR, with high adherence among the subset with available dispensing data. Among viremic initiators, a minority achieved viral suppression, though reductions in viral load were observed. Among suppressed initiators, most maintained suppression. CD4 counts increased in both subgroups, with greater gains among those suppressed at initiation. Modifications to optimized background therapy were infrequent.
Conclusions: In this real‐world, diverse cohort, FTR was well tolerated, with high persistence and, in the dispensing‐data subset, high adherence. It effectively maintained viral suppression among suppressed individuals and provided immunologic benefits across subgroups, including viremic initiators. These findings support FTR as a valuable treatment option for heavily treatment‐experienced PWH.
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BibTeX
@article{elion2026realworld,
title = {{Real‐world use and effectiveness of fostemsavir in a US clinical setting: Insights from Trio Health HIV Research Network}},
author = {Richard Elion and Cassidy Henegar and Isobel McEwen and Andrew Frick and Moti Ramgopal and Steven Santiago and Karam Mounzer and Gregory Huhn and Charles Walworth and Leigh Ragone and Vani Vannappagari},
journal = {HIV Medicine},
year = {2026},
month = sep,
doi = {10.1111/hiv.70303},
url = {https://doi.org/10.1111/hiv.70303},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Real‐world use and effectiveness of fostemsavir in a US clinical setting: Insights from Trio Health HIV Research Network
AU - Richard Elion
AU - Cassidy Henegar
AU - Isobel McEwen
AU - Andrew Frick
AU - Moti Ramgopal
AU - Steven Santiago
AU - Karam Mounzer
AU - Gregory Huhn
AU - Charles Walworth
AU - Leigh Ragone
AU - Vani Vannappagari
PY - 2026
DA - 2026/09/22
JO - HIV Medicine
DO - 10.1111/hiv.70303
UR - https://doi.org/10.1111/hiv.70303
AB - Objective: To describe real‐world patterns of use, virologic and immunologic outcomes and treatment persistence among people with HIV (PWH) initiating fostemsavir (FTR) in a diverse US cohort. Design: Retrospective cohort study of adults receiving FTR in clinical practice, stratified by baseline viral suppression status. Methods: Adults with ≥1 FTR prescription between July 2020 and August 2023 were included and followed for 12 months. Individuals with trial participation were excluded. Outcomes included virologic suppression (<50 and <200 copies/mL), confirmed virologic failure, viral blips, CD4 changes and immunologic recovery among those with baseline CD4 <350 cells/mm3. Persistence and adherence were assessed using dispensing data and proportion of days covered. Results: Seventy‐seven PWH were included (60% viremic, 40% suppressed). Multidrug resistance was observed in a subset (31%). At 12 months, most individuals remained on FTR, with high adherence among the subset with available dispensing data. Among viremic initiators, a minority achieved viral suppression, though reductions in viral load were observed. Among suppressed initiators, most maintained suppression. CD4 counts increased in both subgroups, with greater gains among those suppressed at initiation. Modifications to optimized background therapy were infrequent. Conclusions: In this real‐world, diverse cohort, FTR was well tolerated, with high persistence and, in the dispensing‐data subset, high adherence. It effectively maintained viral suppression among suppressed individuals and provided immunologic benefits across subgroups, including viremic initiators. These findings support FTR as a valuable treatment option for heavily treatment‐experienced PWH.
SN - 1464-2662
SN - 1468-1293
ER -