Creation of a long-acting rilpivirine prodrug nanoformulation

James R. Hilaire, Aditya N. Bade, Brady Sillman, Nagsen Gautam, Jonathan Herskovitz, Bhagya Laxmi Dyavar Shetty, Melinda S. Wojtkiewicz, Adam Szlachetka, Benjamin G. Lamberty, Sruthi Sravanam, Howard S. Fox, Yazen Alnouti, Prasanta K. Dash, Jo Ellyn M. McMillan, Benson J. Edagwa, Howard E. Gendelman

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Antiretroviral therapy requires lifelong daily dosing to attain viral suppression, restore immune function, and improve quality of life. As a treatment alternative, long-acting (LA) antiretrovirals can sustain therapeutic drug concentrations in blood for prolonged time periods. The success of recent clinical trials for LA parenteral cabotegravir and rilpivirine highlight the emergence of these new therapeutic options. Further optimization can improve dosing frequency, lower injection volumes, and facilitate drug-tissue distributions. To this end, we report the synthesis of a library of RPV prodrugs designed to sustain drug plasma concentrations and improved tissue biodistribution. The lead prodrug M3RPV was nanoformulated into the stable LA injectable NM3RPV. NM3RPV treatment led to RPV plasma concentrations above the protein-adjusted 90% inhibitory concentration for 25 weeks with substantial tissue depots after a single intramuscular injection in BALB/cJ mice. NM3RPV elicited 13- and 26-fold increases in the RPV apparent half-life and mean residence time compared to native drug formulation. Taken together, proof-of-concept is provided that nanoformulated RPV prodrugs can extend the apparent drug half-life and improve tissue biodistribution. These results warrant further development for human use.

Original languageEnglish (US)
Pages (from-to)201-211
Number of pages11
JournalJournal of Controlled Release
StatePublished - Oct 2019


  • Antiretroviral therapy
  • Long-acting slow effective release antiretroviral therapy
  • Monocyte-derived macrophages
  • Nanoformulation
  • Prodrugs
  • Rilpivirine

ASJC Scopus subject areas

  • Pharmaceutical Science


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