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Tenofovir DF to TAF improves bone and renal safety

Replacement of Tenofovir DF to TAF improves bone and renal health

S Replacement of Tenofovir DF for TAF suffers, a lot, with the bid of, say .... Tooth AF *: It is known by all scientific community that the exchange of tenofovir DF for TAF is much better for renal health and for bone health. They are, without wanting to insult the club of the worms, a great bunch of worms

Tenofovir DF replacement for TAF is scientifically proven to improve quality of life by decreasing bone loss and complications with the kidneys

 

Tenofovir DF Exchange for TAF: Posted in: 26 February 2018

People with HIV that connects the old tenofovir disoproxil fumarate ™ (TDF) formulation of tenofovir ™ alafenamide ™ (TAF) were more efficient to maintain viral suppression and showed improvement in both the bone density and kidney function, based on their biomarkers, according to studies presented in2016 ASM Microbe conferenceLast month in Boston.

Gilead Sciences "owns the brand tenofovir disoproxil fumarate ™ (brand nameVireadAnd one component ™Complera Atripla and Truvada and coformulações Stribild) Is one of the antiretroviral drugs most used in Anti Retroviral Therapy (ART) and has been considered generally safe and well tolerated but can cause bone loss immediately after the start of treatment and lead to kidney problems in susceptible individuals.

Tenofovir DF to TAF: The active agent tenofovir diphosphate, is "delivered" more efficiently to the cells and this is a kind of "plus" that can not be ignored.

I have read, not sure what would have been the reliable source that has given me this context, and since then I wonder about the whys of time dilation with regard to shifting from the better to the worse. I did not need to think much, but I did not remember which text it was in, and because I have tried to use a more personal and human posture (Yes E. Mandetta, you're right, people who see here also need a lap! I wanted so much yours, in that promise ...).

Well, what keeps them from acting decently is this:


TAF ™
It is a new prodrug ™, which provides the active tenofovir diphosphate agent more efficiently to the cells. It produces adequate intracellular drug levels, with a much smaller dose, which means lower concentration and lower in blood plasma drug exposure to bones, the kidneys and other organs and tissues. TAF is a componentOdefsey Genvoya,And co-formulationsDescovyrecently approved for use in the European Union and the USA.

Edwin De Jesus from Orlando Immunology Center and colleagues presented a poster describing the results of 96 week study of Gilead GS-US-292-0109 a study phase 3 in people with viral suppression on a regimen containing TDF whether they It is listed in the same treatment or connected to a system containing TAF.

Exchange from Tenofovir DF to TAF: a study with almost 1500 people

The study included 1436 people with HIV who had undetectable viral load (<50 copies / ml) Basal. About 90% were men, two-thirds were white, about 19% were black (a group of higher risk for kidney disease)The median age was about 41 years and the mean cell count was approximately CD4 670 cells / mm3. They had to be close to normal renal function at baseline, with an estimated glomerular filtration rate (eGFR) above 50 ml / min; the average rate was about 106 ml / min

Participants were takingAtripla

At the time of entry into the study, participants were takingAtripla(Efavirenz / TDF / emtricitabine)Stribild(Elvitegravir / cobicistat / TDF / emtricitabine), driven by Atazanavir /Reyataz () plusTruvada(TDF / emtricitabine). They were randomly assigned (2: 1) to stay in this regimen or switch toGenvoya(Elvitegravir / cobicistat / TDF / emtricitabine).

The International AIDS Society Conference last summer, reported in a survey that in 48 weeks, participants who were linked to regimens containing TDF toGenvoyaThey were significantly better able to maintain viral suppression and had significant improvements in bone mineral density (BMD) of the hip and spine and markers of renal function.

Tenofovir DF switching to TAF: Dr De Jesus reported that in 96 weeks, both schemes remained highly effective, butGenvoyahad a statistically significant advantage edgea

Dr De Jesus reported that in 96 weeks, both schemes remained highly effective butGenvoyahad a statistically significant edge advantage: 93% people who switched to the TAF scheme had undetectable viral loads compared to 89% of those who remained in their PTO scheme; the results were similar regardless of the regimen they were in and switched to the TDF scheme. Only 2% of participants in both groups had failed therapy, but people in the TDF arm were more likely than not to attend test collections that would collect viral load data (5% vs. 9%).

AEditor's Note:

This is a very relevant fact and can be the true of the balance that would explain why this "significant improvement and, in my opinion, in such an important study, even the collection of this material would have to be done anyway, even if the domicile, since we are not now able to imagine the whys (yes, in the plural) for the subject of the research to be absent from something so important, a study protocol) where he himself would be misinterpreted - as exploit, and bad For example, I missed my last count of CD4 and CV. MAs was with 1160 from CD4 and my viral load has remained undetectable for almost ten years) ... End of the editor's note.

Tenofovir DF for TAF: regimens were generally safe and well tolerated

All regimens were generally safe and well tolerated, but againGenvoyaI had an advantage: 0,9% in users of group therapy with TAF who had stopped treatment due to adverse events compared to 2,5% in the TDF group.

The bone density of the spine increased 2,0% by TAF switches and decreased -0,3% in the group following the continuation of therapy with TDF; Bone density of the hip aumentarou 2,1% and fell in -0,6%, respectively.

From Tenofovir DF to TAF: At 96 weeks (less than 10 years), people switching from tenofovir DF to TAF saw significant reductions in osteoporosis (brittle bones)

At 96 weeks, people who switched from tenofovir DF to TAF saw significant reductions in osteoporosis (brittle bones) or osteopenia (less severe bone density decrease).

People who switched from tenofovir DF to TAF experienced significant improvements in renal function markers (serum creatinine, phosphate, and excretion of uric acid, albumin, and proteins in the urine), while those who remained on TDF regimens worsened.

There were two adverse events related to renal function leading to switching on TAF group (AKI and tubulo interstitial nephritis) and five in the TDF group (chronic kidney disease, Fanconi syndrome, renal colic and two cases of elevated levels of creatinine in the blood).

Tenofovir DF for TAF associated with worse blood lipid results

However, the TAF group had the worst results of blood lipids. Tenofovir is known to reduce lipid levels and the lowest concentration of TAF had a lesser effect than those kept in TDF system.

The fasting lipid levels were higher in TAF group than in the TDF group and 8 5%% vs began lipid-lowering drugs.

"Patients who switched to [Genvoya] From a scheme based on TDF were significantly more likely to keep the successful virological suppression "and" had significant improvements in spine and hip BMD; They had significant reductions in osteopenia and osteoporosis, and showed significant improvement in proteinuria, and other markers of renal function, "the researchers concluded.

Exchange of Tenofovir DF for TAF: data suggest that switching from TDF to TAF may be associated with reduced risk of osteoporosis and fracture, as well as long-term fragility ...

A study by E. Turner Overton University of Alabama at Birmingham and colleagues looked in more detail in bone loss among people under therapy with tenofovir. Its print presents an analysis of changes in bone mineral density, parathyroid hormone (PTH, a hormone that regulates calcium and phosphate metabolism) and serum levels of bone turnover markers (P1NP and CTx) by week 48 in people changed regimens containing TDF toGenvoyain the same study.

In addition to the previously reported gains at the spine and hip bone density, the average levels of PTH decreased after switching toGenvoyaWhile levels in the TDF group decreased. The biomarkers of bone turnover decreased significantly in the group that was interrupted.

"These data suggest that the PTO switching TAF may be associated with reduced risk of osteoporosis and fracture, as well as long-term weakness," the researchers concluded - an important consideration in groups such as people with HIV ranging live and most require lifelong greater amount of HAART.

Tenofovir DF To TAFFinally, Gregory Huhn of the Chicago Core and colleagues analyzed the renal outcomes among people considered to be at high risk for chronic kidney disease (CKD) who switched from TDF to TAF in the same trial. Most physicians advise that people with poor kidney function should not use PTO and current PTO and prescribe instructions that include dose reductions for people with pre-existing kidney failure.

And it would be appropriate to infer that But it may be safer for people with kidney dysfunction to use the formulation with TAF.

The team Huhn, classifying participants into two groups according to high or low risk for chronic kidney disease (CKD). The high risk group had two or more predisposing factors including female gender, black race, 50 years of age or older, one CD4 count <200 cells / mm³, abnormal blood lipids, high blood pressure, diabetes, use of NSAIDs ( anti-inflammatory drugs, non-steroidal), and clinical or subclinical renal adverse events at baseline; low-risk group had zero or one factor. A total of 323 people who changed TAF and 168 who remained in TDF regimens were considered high risk.

Outcomes of interest included incident or new cases of chronic kidney disease, defined as eGFR <60 ml / min between the people who started with> 60; abandonment of drug UseThe due to adverse events related to the Kidneys; and changes in the urine protein biomarkers including renal and albumin and retinol-binding protein and creatinine as well as the beta-macroglobulin 2- for creatinine ratios.

DRC incident developed in 2% of TAF switches and 3% of patients who continued with formulção TDF considered high risk - was not a significant difference. Among those considered at low risk for CKD, 1% of TAF switches and 2% who stayed at TDF developed CKD, which reached statistical significance. In the high-risk category two switches of TAF and two TDF users discontinue use of these coformulações due to adverse events related to renal failure, as did three users of low-risk but low risk TDF TAF Allegiant (translator's note: In all features of "translation I know no Internet gave me nothing other than to translate Allegiant Allegiant - remain in the search, but for now, impossible). A single high-risk patients who remained in the study with TDF developed Fanconi syndrome.

Tenofovir DF for TAF: Data suggest that switching from TDF to TAF may be associated with reduced risk of osteoporosis and fracture, as well as long-term fragility.

Urine protein and albumin decreased in the arm of the study that discontinued TAF therapy, while increasing the number of participants who switched to TDF therapy at all risk categories for CKD. However, only high-risk participants have had a substantial change - an increase of 33%. Decreases in tubular proteinuria between switches for TAF and increase in users who continued with TDF therapy were seen in high, medium and low risk groups of CKD.

Based on these findings, the researchers summarized: People at high risk for kidney disease who switched toGenvoya"With low incidence of CKD," had not abandoned due to renal failure tubulopática*And saw significant reductions in proteinuria and tubular proteinuria.

Tenofovir DF to TAF:

"These results demonstrate durable efficacy and better safetykidney Genvoya [] As a switching scheme for adults with underlying risk for CKD, "he said.

Editor's note: because it was not part of the text I put, below, the definition of what is theretubolopática renal nsuficiência:is the sudden loss of the ability of your kidneys filter out waste, salts and fluids from the blood. When this happens, the waste can reach dangerous levels and affect the chemical composition of the blood, which can get out of balance.

Also called acute kidney injury, failure is common in patients who are already in the hospital with some other condition. You can develop rapidly over a few hours or more slowly over several days. People who are seriously ill and require intensive care are at increased risk of developing acute renal failure.

Acute renal failure can be fatal and requires intensive treatment. However, it may be reversible. It depends on the state of health of the patient.read more(Opens in another tab, a site in Portuguese)

Liz Highleyman

Produced in collaboration between the Aidsmapit's theHivandhepatitis.com

Translated by Claudio Souza the original English the linkSwitching to new tenofovir alafenamide keeps virus in check and Improves kidney and bone health

Reviewed by Mara Macedo

Originally Published: 11 July 2011 and 18 July 2016

Soropositivo.Org1º since August 2000 in the fight against discrimination, AIDS, the Prejudice. There is life with HIV!

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