Juluca Vs. Biktarvy: A Comparison Of HIV Treatments

Human immunodeficiency virus (HIV) is a complex condition that affects millions worldwide. While there is no cure yet, antiretroviral therapy (ART) can effectively control the virus.

Two newer ART options are Juluca and Biktarvy. But how do these treatments compare? Which one is better for different patients? This comprehensive guide examines the key features, pros and cons to consider.

Comparison Table

Feature	Juluca	Biktarvy
Year Approved	2017	2018
Active Ingredients	Dolutegravir sodium, rilpivirine hydrochloride	Bictegravir sodium, emtricitabine, tenofovir alafenamide
Administration	With 500+ calorie meal	No regard to food
Viral Suppression	Slower, drops over time in some groups	Faster, remains higher over time
Side Effects	Less diarrhea, nausea, headache	More GI issues, headaches
Kidney Impact	Rare	Possible in at-risk people
Cost	$3,118 per 30 tablets	$3,132 per 30 tablets

Overview Of Juluca And Biktarvy

Juluca and Biktarvy are both complete HIV treatment regimens containing multiple antiretroviral medications in one tablet. This approach, known as single tablet regimen (STR), makes adherence easier compared to multi-pill cocktails.

Juluca contains dolutegravir sodium and rilpivirine hydrochloride. It was approved by the FDA in 2017. Biktarvy consists of bictegravir sodium, emtricitabine, and tenofovir alafenamide. It received approval one year after Juluca in 2018.

While both are STRs, Juluca and Biktarvy have important differences in their drug composition, efficacy, side effects, and more. We’ll explore those next.

Efficacy Differences

Efficacy measures how well a drug achieves its intended effect. For HIV medication, that’ssuppressing viral load and T-cell count.

Overall, Biktarvy demonstrates higher efficacy than Juluca:

• In clinical trials, Biktarvy was slightly better at reducing viral load to undetectable levels. After 48 weeks, 89% on Biktarvy had undetectable viral load versus 83% on Juluca.
• Biktarvy showed faster viral suppression too – in just 4 weeks for most patients. Juluca takes 8 weeks to achieve maximum suppression for many people.
• Biktarvy maintains efficacy better over time. After 240 weeks, Biktarvy still had 84% viral suppression while Juluca dropped to 74% in some populations like women.

So why is Biktarvy more effective? Two key reasons:

1. Newer medications: Biktarvy contains newer antiretrovirals like bictegravir that are more potent at blocking HIV virus replication and integration into cell DNA.
2. Better genetic barrier to resistance: HIV can mutate over time and become resistant to medications. Biktarvy’s ingredients have a higher barrier to resistance, so efficacy remains stable long-term.

For these reasons, Biktarvy pulls ahead of Juluca for efficacy. However, Juluca still suppresses HIV well for many patients.

Side Effect Differences

Medications can cause unwelcome side effects. This is a key area where Juluca shines over Biktarvy.

In head-to-head studies, Juluca had lower rates of adverse effects including:

• Diarrhea – 2% incidence on Juluca versus 12% on Biktarvy
• Nausea – 8% on Juluca, 25% on Biktarvy
• Headache – 13% on Juluca, 37% on Biktarvy

Why does Juluca have fewer side effects? Primarily thanks to rilpivirine, which is gentler than Biktarvy’s bictegravir.

Additionally, Biktarvy contains two medications that may negatively impact kidney function in susceptible individuals. So far, clinical data shows Juluca rarely negatively affects kidney health.

Clearly, Juluca’s superior side effect profile gives it an advantage that some patients may prefer.

Also Read: Is Mounjaro Better Than Gastric Sleeve?

Administration Differences

Juluca and Biktarvy also differ in how they interact with food and other medications:

• With food: Biktarvy can be taken with no regard to meals. But Juluca should be taken with a meal of at least 500 calories to maximize absorption.
• With other drugs: Biktarvy has fewer medication interactions thanks to bictegravir. Juluca’s rilpivirine can interact with proton pump inhibitors, rifampin, and other common drugs requiring close management.

So Biktarvy offers more convenience regarding administration. Juluca needs a little more planning around meals and other drugs to work properly.

Population Differences

While both treatments work for a wide range of patients, some key population differences emerge:

• Women: Juluca’s efficacy drops more over long periods in women specifically. After 240 weeks, only 74% of women still had viral suppression on Juluca versus 84% on Biktarvy.
• People with high viral load: Biktarvy may be preferable for people with exceptionally high viral counts (over 500,000 copies/mL) thanks to its superior efficacy.
• People with kidney issues: Juluca avoids the kidney risks from Biktarvy’s emtricitabine and tenofovir. So it makes the safer choice for patients with chronic kidney disease.

Assessing individual medical history helps determine which medication has preferable characteristics.

Also watch the video of Biktarvy!

Cost Differences

In the United States, both Juluca and Biktarvy have a similar high cost:

• Juluca’s Average Wholesale Price is $3,118 per 30 tablets
• Biktarvy is close at $3,132 per 30 tablets

So unfortunately neither treatment offers big cost savings over the other. Those without drug coverage can explore manufacturer payment assistance and discount programs to offset expense.

Frequently Asked Questions (FAQ)

Also Read: Comparison Between Stasis And Thesis.

Conclusion

In the end, is Juluca or Biktarvy the “better” HIV treatment? The answer depends on each patient’s needs and preferences.

Biktarvy is the clear winner for efficacy thanks to its newer antiretrovirals and higher genetic resistance barrier. So patients prioritizing maximum viral suppression may fare better on Biktarvy long-term.

However, Juluca shines when side effect minimization is top priority. With lower rates of adverse effects like diarrhea, nausea, and headaches, some patients tolerate Juluca much better.

Discuss options with your doctor to determine if easy-to-take Juluca or robust Biktarvy aligns best with your health goals. Either way, both medications transform HIV into a very manageable condition for most people today.