Dapivirine Ring

Dapivirine (DPV) Ring is an antiretroviral vaginal ring pioneered by the International Partnership for Microbicides (IPM) pending for regulatory review. It is designed as a long-acting form of HIV prevention for at-risk women, particularly in developing nations such as sub-Saharan Africa. IPM has rights to both the medication and the medical device. A total of four rings with different drug diffusion systems and polymer composition have been developed by IPM. The latest design, Ring-004, is a silicone polymer matrix-type system capable of delivering DPV intravaginally in a sustained manner.

From 2009 to 2012, two Phase I and one Phase I/II safety trials of the DPV ring were conducted by IPM. Results deemed the device to be well-tolerated and safe. In 2012, two Phase III studies were sequentially launched––The Ring Study and ASPIRE. The Ring Study was sponsored by IPM. ASPIRE was sponsored by Microbicide Trials Network (MTN). Both studies indicated the effectiveness of the ring in reducing the risk of HIV transmission. In July 2016, two open-label studies, DREAM and HOPE were launched following the successful results from the Phase III studies. Insights on the utilisation of the tool by women were illuminated. DPV Rings were given to the former Phase III trial participants for one whole year. HOPE ended in October 2018 and DREAM ended in January 2019. In 2019, the results of both studies were published which indicated up to 54% efficacy.

The World Health Organization today recommended that the dapivirine vaginal ring may be offered as an additional prevention choice for women at substantial risk.^[1]

The risk of DPV resistance; ring's negative impact on intimate relationships, and inaccurate rumours surrounding the device are potential drawbacks limiting the overall implementation of the technology. Alternative long-acting rings with similar functionality to the DPV Ring are under development by IPM.^[2]