Antidote Research Articles

Sugammadex Reduced the Incidence of Postoperative Pulmonary Complications in Susceptible Patients Identified by ARISCAT Risk Index: Systematic Review and Meta-analysis.

The efficacy of sugammadex on postoperative pulmonary complications (PPCs) in susceptible patients, compared with neostigmine, remains indeterminate. The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Group Investigators proposed a risk index for the early identification of susceptible patients, with excellent externally validated discrimination ability. Meta-analytical techniques were applied to evaluate the efficacy of sugammadex on PPCs in patients with ARISCAT-defined risk factors. The study is registered on PROSPERO, number CRD42021261156. We searched PubMed, Scopus, Embase, Cochrane library, GreyNet, and OpenGrey for eligible randomized controlled trials (RCTs) without restricting the language or year of publication. Twelve RCTs consisting of 1182 patients susceptible to PPCs were included. A robust reduction was observed on the incidence of PPCs in susceptible patients who received sugammadex [RR 0.66; 95% CI (0.54, 0.80), p<0.01], with a low level of between-study heterogeneity (I2=45.98%; H2=1.85). Similar protective effects were also proved in avoiding residual neuromuscular block (NMB) [RR 0.25; 95% CI (0.11, 0.56); p<0.01], atelectasis [RR 0.74; 95% CI (0.59, 0.95); p=0.02], pneumonia [RR 0.49; 95% CI (0.28, 0.88); p=0.02], and respiratory failure [RR 0.61; 95% CI (0.39, 0.96); p=0.03]. No difference was observed regarding adverse events [RR 0.85; 95% CI (0.72, 1.01); p=0.06]. Low to moderate quality of evidence demonstrated the edge of sugammadex over neostigmine for NMB reversal in reducing the likelihood of PPCs and residual NMB in patients with ARISCAT-defined risk factors. Clinicians may reassess the type of reversal agent when treating patients susceptible to PPCs.

AMA Backs Making Overdose Reversal Meds Accessible in Schools

AMA Backs Making Overdose Reversal Meds Accessible in Schools

Versatile Production of Multivariate, Hyperdimensional End Group and Main Chain Functionalized Polyolefins.

The (stereoselective) living coordinative copolymerization of 1-alkenes with 4-aryl-1,6-heptadienes, in both the absence and presence of multiple equivalents of a reversible chain transfer agent, is established as a highly versatile strategy for production of multivariate hyperdimensional functionalized semi-crystalline or amorphous polyolefins that optionally possess either mono- or difunctionalized (telechelic) end-groups in combination with a programmable level of incorporation of orthogonal functional groups within the main-chain. The non-conjugated diene comonomers are readily obtained from a diverse range of aryl carboxaldehyde precursors through a one-step bis-allylation process. These results serve to provide a new platform for exploring the science and technology of a vast new landscape of functionalized classes of polyolefins that are now accessible in practical and scalable quantities.

Versatile Production of Multivariate, Hyperdimensional End Group and Main Chain Functionalized Polyolefins

AbstractThe (stereoselective) living coordinative copolymerization of 1‐alkenes with 4‐aryl‐1,6‐heptadienes, in both the absence and presence of multiple equivalents of a reversible chain transfer agent, is established as a highly versatile strategy for production of multivariate hyperdimensional functionalized semi‐crystalline or amorphous polyolefins that optionally possess either mono‐ or difunctionalized (telechelic) end‐groups in combination with a programmable level of incorporation of orthogonal functional groups within the main‐chain. The non‐conjugated diene comonomers are readily obtained from a diverse range of aryl carboxaldehyde precursors through a one‐step bis‐allylation process. These results serve to provide a new platform for exploring the science and technology of a vast new landscape of functionalized classes of polyolefins that are now accessible in practical and scalable quantities.

Comparison the effects of sugammadex and neostigmine/atropine on cognitive functions in bariatric surgery patents: Randomized controlled trial

Background/Aim: A recently introduced drug, sugammadex, can be a good alternative to conventional neuromuscular blockade reversal agents, such as neostigmine. This choice is of great importance, especially in the patients in whom it would be wise to avoid cholinergic side effects. The aim of this study was to compare the effects of sugammadex and the combination of neostigmine/atropine on post-operative cognitive dysfunction in bariatric surgery patients. Methods: This randomized controlled trial included a total of 90 patients with American Society of Anesthesiologists (ASA) I–III physical status and body mass index &gt;30 who were scheduled for elective sleeve gastrectomy were recruited for the study after obtaining ethics committee approval. Written consent was obtained from each patient. The exclusion criteria consisted of several parameters: lack of consent, co-existing muscular diseases, and severe cardiovascular diseases (New York Heart Association [NYHA]). The patients were randomly divided into two groups, and the randomization was performed by the investigator using previously prepared envelopes. In both groups, Mini Mental State Examination (MMSE) was performed before the operation. The patients’ memory, attentive executive functions, and motor skills were evaluated as part of a control cognitive evaluation. After the operation while in the post-anesthesia care unit and when the Modified Aldrete Recovery Score was ≥9, the MMSE evaluation was repeated one and six hours later. Results: The pre-operative MMSE results were similar in both groups. In the post-operative period, MMSEpo, MMSEpo1, and MMSEpo6 values were not significantly different between the groups. When a detailed examination of MMSEpo data was performed, it was determined that the MMSE scores were 20–25 in 14 patients (32.6%) in Group N/A and six patients (14.6%) in Group S. In Group N/A, the percentage of patients with MMSE 20–25 was significantly higher than that of Group S (X2=3.807; P=0.046). Conclusion: In this study, sugammadex produced less effects on cognitive functions when compared with neostigmine/atropine combination. The neostigmine/atropine combination produced mild effects on cognitive functions in the first hour of recovery.

Retrospective Analysis of Sugammadex Use in Adolescent Females on Progestin-Containing Contraceptives

Sugammadex, a novel neuromuscular blockade reversal agent, functions as a steroid binder postulated to decrease hormone exposure used within progestin-containing contraceptive medications. Thus, alternative non-medication contraceptive methods are recommended to prevent unplanned pregnancies. The study aims were to evaluate sugammadex use in adolescent females prescribed a progestin-containing contraceptive and positive pregnancy screening frequency. We hypothesized that sugammadex use is infrequent in this population and no pregnancy screens would be positive. This is a retrospective observational cohort study utilizing the TriNetX electronic health record database of female subjects aged 12-21 years reported to be prescribed sugammadex. The data collected were analyzed for demographic characteristics, International Classification of Diseases 9th and 10th edition diagnostics, medication, procedural codes, progestin-containing medication timing, and timing of pregnancy screening. We included 18,686 subjects (contraceptive group, 2017 [10.8%], and no contraceptive group, 16,669 [89.2%]). Both groups had similar frequencies of pregnancy screening (contraceptive group, 54 [2.7%], vs no contraceptive group, 366 [2.2%]). Of the contraceptive group, 1 (0.05%) subject, 17 years of age, was confirmed to have a positive pregnancy screen 35 days after surgery. We found that sugammadex may be administered to adolescent females prescribed progestin-containing contraceptives, but positive pregnancy screens are rare. Effective counseling, use of nonhormonal contraceptives 7 days after sugammadex administration, and the theoretical reproductive risks of this agent may have contributed to these findings. Continued counseling after sugammadex use in the adolescent population is recommended to avoid the occurrence of unplanned pregnancies.

Mechanism of Modified Ether Amine Agents in Petalite and Quartz Flotation Systems under Weak Alkaline Conditions

To investigate the flotation separation behavior of petalite and quartz, various methods were employed in this study. These included micro-flotation experiments, a contact angle analysis, zeta potential analysis, Fourier transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS) to explore the separation mechanism of a modified ether amine reagent (L0-503) for petalite and quartz under weakly alkaline conditions. The micro-flotation test results indicated that the modified ether amine collector had a higher collecting ability for quartz than for petalite, with a maximum recovery rate of 93.2% for quartz and a recovery rate consistently below 14% for petalite in the presence of L0-503. This indicates that the modified ether amine reagent can be used as a reverse flotation agent for separating petalite and quartz. The separation mechanism results showed that the modified ether amine reagent had a significantly higher adsorption capacity for quartz than for petalite due to a strong reaction between the quartz and the secondary amine (-NH=) on the modified ether amine collector. Additionally, the electrostatic force and hydrogen bonding between the reagent and quartz further enhanced the adsorption, while no reaction occurred between the reagent and petalite.

Deterioration free discharge comparison of andexanet-alfa and prothrombin complex concentrates (PCC) for reversal of factor Xa inhibitor associated bleeds.

Given the paucity of comparative efficacy data and the difference in cost between andexanet-alfa and prothrombin complex concentrates (PCC), debates continue regarding optimal cost-effective therapy for patients who present with major bleeding associated with oral factor Xa inhibitors. Available literature comparing the cost-effectiveness of the reversal agents is limited, and the large difference in price between therapy options has led many health systems to exclude andexanet-alfa from their formularies.To evaluate the clinical outcomes and cost of PCC compared to andexanet-alfa for patients with factor Xa inhibitor associated bleeds.We performed a quasi-experimental, single health system study of patients treated with PCC or andexanet-alfa from March 2014 to April 2021. Deterioration-free discharge, thrombotic events, length of stay, discharge disposition, and cost were reported.170 patients were included in the PCC group and 170 patients were included in the andexanet-alfa group. Deterioration-free discharge was achieved in 66.5% of PCC-treated patients compared to 69.4% in the andexanet alfa-treated patients. 31.8% of PCC-treated patients were discharged home compared to 30.6% in the andexanet alfa-treated patients. The cost per deterioration-free discharge was $20,773.62 versus $5230.32 in the andexanet alfa and 4F-PCC group, respectively.Among patients that experienced a bleed while taking a factor Xa inhibitor, there was no difference in clinical outcomes for patients treated with andexanet-alfa compared to PCC. Although there was no difference in the clinical outcomes, there was a significant difference in cost with andexanet-alfa costing approximately four times as much as PCC per deterioration-free discharge.

Utilization and outcomes of protamine after percutaneous left atrial appendage occlusion.

The aim of this study was to describe the use pattern and outcomes of protamine administration for heparin reversal among sites performing percutaneous left atrial appendage occlusion (LAAO). We identified 45,135 patients who underwent LAAO at 243 hospitals participating in Vizient® Clinical Database between January 1, 2016 and December 31, 2021. Patients were stratified according to protamine administration after the procedure. Outcomes of interest included vascular complications, major bleeding, ischemic events, and same-day discharge. A total of 40,278 patients were included in the propensity-matched comparison, of whom 50% received protamine after the LAAO procedure. The use of protamine varied across hospitals, with 88 hospitals (36.2%) using protamine in >75% of cases and 32 hospitals (13.1%) not using protamine at all. Major bleeding occurred less frequently in the protamine group compared with the control group (2.4% vs. 2.8%, p = 0.03). Major vascular complications and pericardial tamponade were rare but slightly higher in the protamine group (0.8% vs. 0.6%, p = 0.04) and (1.0% vs. 0.8%, p = 0.01), respectively. There were no differences in the rates of ischemic or hemorrhagic stroke, all-cause mortality, or the rate of any major adverse event between the two groups. Same-day discharge was more frequent in the protamine group (12.3% vs 9.4%, p ≤ 0.001). Protamine is used in approximately 50% of LAAO procedures and is associated with lower bleeding events and higher rates of same-day discharge. The higher vascular complication and tamponade is likely due to its ad-hoc use as a reversal agent in these patients.

Mycophenolate Mofetil Use in Pediatric Immune Thrombocytopenia Refractory to First-line Therapy: a Single-center Experience.

Most children treated for immune thrombocytopenia remit during the first year following diagnosis. For the ∼40% who develop persistent or chronic disease, second-line treatment options include immunomodulation and thrombomimetic agents. While immunomodulators target the underlying mechanism, prolonged immunosuppression may increase the risk of infection. We report the use of the reversible immunomodulating agent mycophenolate mofetil (MMF) in 16 pediatric patients with immune thrombocytopenia refractory to first-line treatment. Using escalating doses up to 2400mg/m 2 /d, MMF treatment resulted in a 73% response rate. Adverse events were mostly mild and tolerable. Complete responders have been successfully tapered off MMF with sustained responses.

P64: Rotational Thromboelastometry Predictors of Thrombosis in Patients with a Left Ventricular Assist Device

Background: Left ventricular assist devices (LVADs) prolong survival and improve quality of life for patients with advanced heart failure. They are also associated with a variety of complications including thrombotic events. Viscoelastic testing with rotational thromboelastometry (ROTEM) can be used to screen for coagulopathy in a variety of conditions, however, its utility in patients with an LVAD remains unclear. The purpose of this study was to identify ROTEM characteristics associated with thrombosis in hospitalized patients with an LVAD. Methods: This was a single-center, retrospective cohort study of patients with an LVAD who were hospitalized from January 1, 2013, to December 1, 2022. ROTEMs collected during the first 24 hours of hospitalization from patients with confirmed thrombosis were compared to those of patients without thrombosis. Thrombosis was defined as either ischemic stroke, pump thrombosis, or arterial or venous thrombi. Up to five ROTEMs each, consisting of INTEM, EXTEM, and FIBTEM, were collected per patient. Exclusion criteria included ROTEMs collected during the patient’s implant hospitalization or bleeding admission, or patient received a parenteral antithrombotic agent, parenteral antiplatelet agent, reversal agent, or blood product within 48 hours of ROTEM collection. A univariable binary logistic regression model was used to estimate the unadjusted effects of each ROTEM characteristic. Type III Wald Chi-square p-values were reported for each variable. Results: A total of 238 ROTEMs were included in the study with 39 in the thrombosis group and 199 in the non-thrombosis group. At baseline, history of a clotting event (56.4% vs. 37.2%, p=0.03) and age (61.9 + 13.8 vs. 56.6 + 15, p=0.04) were higher in the thrombosis group, while the remaining characteristics were similar between both groups. For the primary outcome, there was no statistically significant difference in EXTEM maximum clot firmness between patients with thrombosis compared to patients without thrombosis (71.6 + 10 vs. 69.7 + 7.9, p=0.20). For secondary outcomes, FIBTEM maximum clot firmness (31.1 + 13.0 vs. 26.8 + 10.6, p=0.03) and FIBTEM amplitude at 20 minutes (30.5 + 12.8 vs. 26.5 + 10.4, p=0.04) were both higher in the thrombosis group compared to the non-thrombosis group. Conclusion: The utility of viscoelastic testing in patients with an LVAD has remained unclear with the limited amount of literature currently available. This study was the first of its class to assess ROTEM characteristics upon hospital admission to screen for coagulopathy in patients with an LVAD. ROTEM characteristics including FIBTEM maximum clot firmness and FIBTEM amplitude at 20 minutes may be utilized as screening tools to identify patients at an increased risk for thrombosis.

EPH131 Estimation of the Population of Patients Eligible for Pirtobrutinib after Covalent Bruton Tyrosine Kinase Inhibitor (CBTKI) Discontinuation in the United States

Pirtobrutinib is a reversible non-covalent BTKi agent that is currently being evaluated in patients with a variety of B-cell malignancies, including Mantle Cell Lymphoma (MCL) (NCT03740529, BRUIN, LOXO-BTK-18001). MCL is a rare condition diagnosed in less than 3,341 people per year in the United States (U.S.). This study was designed to estimate the annual population of patients with MCL who may be eligible for treatment with pirtobrutinib in commercial and Medicare health plans in the U.S.

P65: Predictors of Bleeding with Rotational Thromboelastometry in Patients with a Left Ventricular Assist Device

Purpose: Bleeding events are a significant source of morbidity and mortality in patients with left ventricular assist devices (LVAD). Rotational thromboelastometry (ROTEM) is a form of viscoelastographic testing that provides a real-time analysis of clot initiation, clot strength, and fibrinolysis. There is limited data regarding the use of ROTEM in predicting bleeding events in patients with LVADs post-implantation. Therefore, the purpose of this study is to determine if any component in ROTEM is associated with bleeding events in LVAD patients. Methods: This was a retrospective, single-centered, cohort study of LVAD patients implanted between January 2013 to December 2022 that compared ROTEM values between patients admitted due to bleeding and non-bleeding controls. ROTEM values drawn within 24 hours of separate hospitalizations were included. Patient encounters were excluded for the following reasons: ROTEM drawn after receiving blood or anticoagulant reversal agent, parenteral anticoagulation, or direct oral anticoagulants, and admission related to thrombotic events, index implantation, or device exchange. The primary outcome was to determine if ROTEM values were associated with bleeding events. Results: Of the 327 patient admissions evaluated, 266 patient encounters met inclusion criteria with 59 (22.2%) bleeding events and 207 (77.2%) controls. Of the excluded patients, 28 patients were excluded due to ROTEM drawn after receiving blood or an anticoagulant reversal agent. Baseline characteristics including age, gender, race, ethnicity, device type, last ejection fraction, and indication for implant were similar between groups. Patients admitted for a bleeding event were more likely to have a history of any bleeding event (p=0.01). There was no significant difference seen in the regression analysis evaluating INTEM clot time (p=0.55), INTEM clotting formation time (p=0.45), EXTEM clotting time (p=0.72), FIBTEM clot formation time (p=0.78), and FIBTEM clotting time (p=0.78) for patients experiencing a bleeding event vs those without a bleeding event (table 1). Conclusion: There are no differences in ROTEM values in LVAD patients admitted for bleeding events compared to non-bleeding admissions. Table 1.

Use of NMBA and reversal agent during thyroid surgery with intraoperative neuromonitoring

Neuromuscular blocking agent (NMBA) provides adequate muscle relaxation for intubation and surgery, but their use can interfere with the interpretation of intraoperative neuromonitoring (IONM) signals. Various strategies for the use of NMBA during thyroid surgery with IONM have been proposed for both safe anesthesia and surgery, and adequate quality of IONM. Relaxant-free anesthesia or use of succinylcholine is not recommended as a routine use due to the potential of fatal complications such as laryngeal injury or malignant. Instead, the use of a single dose of rocuronium for intubation with or without a reversal agent has been widely adapted. Though spontaneous recovery of neuromuscular blockade can be achieved without a reversal agent, use of a reversal agent can shorten the time for adequate IONM. Both neostigmine and Sugammadex can be used to reverse the neuromuscular blockade. Neostigmine reverses all types of non-depolarizing NMBA, but can accompany systemic cholinergic effect, and is not effective to deep or higher level of blockade. Sugammadex only reverses the effect of aminosteroid NMBAs, but effective to all levels of blockade. Overall, appropriate strategies for the use of NMBAs and reversal agents are needed to ensure effective IONM without increasing the risk of nerve injury during surgery.

Sugammadex Is Not a Silver Bullet: Caveats Regarding Unmonitored Reversal.

Sugammadex Is Not a Silver Bullet: Caveats Regarding Unmonitored Reversal.

Direct oral anticoagulants or vitamin K antagonists in emergencies: comparison of management in an observational study

BackgroundRestoring hemostasis in patients on oral anticoagulants presenting with major hemorrhage (MH) or before surgical intervention has changed, with the replacement of vitamin K antagonist (VKA) with direct oral anticoagulants (DOACs). ObjectivesTo observe the difference in urgent hemostatic management between patients on VKA and those on DOACs. MethodsA multicenter observational study evaluated the variation in laboratory testing, hemostatic management, mortality, and hospital length of stay (LOS) in patients on VKA or DOACs presenting with MH or urgent hemostatic restoration. ResultsOf the 1194 patients analyzed, 783 had MH (61% VKA) and 411 required urgent hemostatic restoration before surgery (56% VKA). Compared to the international normalized ratio (97.6%), plasma DOAC levels were measured less frequently (<45%), and the time taken from admission for the coagulation sample to reach the laboratory varied widely (median, 52.3 minutes; IQR, 24.8-206.7). No significant plasma DOAC level (<50 ng/mL) was found in up to 19% of patients. There was a poor relationship between plasma DOAC level and the usage of a hemostatic agent. When compared with patients receiving VKA (96.5%) or dabigatran (93.7%), fewer patients prescribed a factor Xa inhibitor (75.5%) received a prohemostatic reversal agent. The overall 30-day mortality for MH (mean: 17.8%) and length of stay (LOS) (median: 8.7 days) was similar between VKA and DOAC patients. ConclusionIn DOAC patients, when compared to those receiving VKA, plasma DOAC levels were measured less frequently than the international normalized ratio and had a poor relationship with administering a hemostatic reversal agent. In addition, following MH, mortality and LOS were similar between VKA and DOAC patients.

High quality colonoscopy: using textbook process as a composite quality measure.

BACKGROUND : High quality colonoscopy is fundamental to good patient outcomes. "Textbook outcome" has proven to be a feasible multidimensional measure for quality assurance between surgical centers. In this study, we sought to establish the "textbook process" (TP) as a new composite measure for the optimal colonoscopy process and assessed how frequently TP was attained in clinical practice and the variation in TP between endoscopists. METHODS : To reach consensus on the definition of TP, international expert endoscopists completed a modified Delphi consensus process. The achievement of TP was then applied to clinical practice. Prospectively collected data in two endoscopy services were retrospectively evaluated. Data on colonoscopies performed for symptoms or surveillance between 1 January 2018 and 1 August 2021 were analyzed. RESULTS : The Delphi consensus process was completed by 20 of 27 invited experts (74.1 %). TP was defined as a colonoscopy fulfilling the following items: explicit colonoscopy indication; successful cecal intubation; adequate bowel preparation; adequate withdrawal time; acceptable patient comfort score; provision of post-polypectomy surveillance recommendations in line with guidelines; and the absence of the use of reversal agents, early adverse events, readmission, and mortality. In the two endoscopy services studied, TP was achieved in 5962/8227 colonoscopies (72.5 %). Of 48 endoscopists performing colonoscopy, attainment of TP varied significantly, ranging per endoscopist from 41.0 % to 89.1 %. CONCLUSION : This study proposes a new composite measure for colonoscopy, namely "textbook process." TP gives a comprehensive summary of performance and demonstrates significant variation between endoscopists, illustrating the potential benefit of TP as a measure in future quality assessment programs.

Design, Synthesis, and Biological Evaluation of Marine Lissodendrins B Analogues as Modulators of ABCB1-Mediated Multidrug Resistance

Multidrug resistance (MDR) caused by ATP-Binding Cassette Subfamily B Member 1 (ABCB1, P-glycoprotein, P-gp) is a major barrier for the success of chemotherapy in clinics. In this study, we designed and synthesized a total of 19 Lissodendrins B analogues and tested their ABCB1-mediated MDR reversal activity in doxorubicin (DOX)-resistant K562/ADR and MCF-7/ADR cells. Among all derivatives, compounds D1, D2, and D4 with a dimethoxy-substituted tetrahydroisoquinoline fragment possessed potent synergistic effects with DOX and reversed ABCB1-mediated drug resistance. Notably, the most potent compound D1 merits multiple activities, including low cytotoxicity, the strongest synergistic effect, and effectively reversing ABCB1-mediated drug resistance of K562/ADR (RF = 1845.76) and MCF-7/ADR cells (RF = 207.86) to DOX. As a reference substance, compound D1 allows for additional mechanistic studies on ABCB1 inhibition. The synergistic mechanisms were mainly related to the increased intracellular accumulation of DOX via inhibiting the efflux function of ABCB1 rather than from affecting the expression level of ABCB1. These studies suggest that compound D1 and its derivatives might be potential MDR reversal agents acting as ABCB1 inhibitors in clinical therapeutics and provide insight into a design strategy for the development of ABCB1 inhibitors.

Sugammadex Use for Reversal in Nonobstetric Surgery During Pregnancy: A Reexamination of the Evidence.

Sugammadex Use for Reversal in Nonobstetric Surgery During Pregnancy: A Reexamination of the Evidence.

Strategic self-limiting production of infectious HIV particles by CRISPR in permissive cells

Post-translational glycosylation of the HIV-1 envelope protein involving precursor glycan trimming by mannosyl oligosaccharide glucosidase (MOGS) is critically important for morphogenesis of virions and viral entry. Strategic editing of the MOGS gene in T lymphocytes and myeloid origin cells harboring latent proviral DNA results in the production of non-infectious particles upon treatment of cells with latency reversal agents. Controlled activation of CRISPR-MOGS by rebound HIV-1 mitigates production of infectious particles that exhibit poor ability of the virus to penetrate uninfected cells. Moreover, exclusive activation of CRISPR in cells infected with HIV-1 alleviates concern for broad off-target impact of MOGS gene ablation in uninfected cells. Combination CRISPR treatment of peripheral blood lymphocytes prepared from blood of people with HIV-1 (PWH) tailored for editing the MOGS gene (CRISPR-MOGS) and proviral HIV-1 DNA (CRISPR-HIV) revealed a cooperative impact of CRISPR treatment in inhibiting the production of infectious HIV-1 particles. Our design for genetic inactivation of MOGS by CRISPR exhibits no detectable off-target effects on host cells or any deleterious impact on cell survival and proliferation. Our findings offer the development of a new combined gene editing-based cure strategy for the diminution of HIV-1 spread after cessation of antiretroviral therapy (ART) and its elimination.