Replacement of Tenofovir DF for 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 binding from the old tenofovir disoproxil fumarate ™ (TDF) formulation of tenofovir ™ alafenamide ™ (TAF) were more efficient in maintaining suppression of viral load and showed improvements in both bone density and renal function, based on their biomarkers, according to studies presented in the 2016 ASM Microbe conference last month in Boston.
Gilead Sciences "which owns the brand tenofovir disoproxil fumarate ™ (brand name Viread ™ and a component of the Complera Atripla and Truvada co-formulations and Stribild ) is one of the most widely used antiretroviral drugs in antiretroviral therapy (ART) and has been generally considered safe and well tolerated but may cause loss of bone mass soon after initiation 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, and I am not sure what would have been the reliable source that gave me this context, and since then I wonder about the whys of time dilation in relation to the change in the wholeness of the best in place of the worst. 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 ™ is a new prodrug ™, which delivers the active agent tenofovir diphosphate, more efficiently to the cells. It produces adequate intracellular drug levels at a much lower dose, which means lower blood plasma concentration and lower drug exposure to our bones, kidneys and other organs and tissues. TAF is a component of the Odefsey Genvoya,, and co-formulations,Descovy recently approved for use in the European Union and the USA.
Edwin De Jesus of the Orlando Immunology Center and colleagues presented a poster describing the 96 week results of the Gilead GS-US-292-0109 study, a 3 phase study, in which people with viral suppression over a TDF-containing regimen either had if listed in the same treatment or bound to a TAF-containing regimen.
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) baseline. About 90% were men, two thirds were white, about 19% were black (a group at highest risk for kidney disease), the median age was about 41 years and the mean CD4 cell count was approximately 670 cells / mm3. They had to have near-normal renal function at baseline with an estimated glomerular filtration rate (eGFR) above 50 ml / min; the mean rate was about 106 ml / min
Participants were taking Atripla
At the time of entry into the study, participants were taking Atripla (efavirenz / TDF / emtricitabine) Stribild(Elvitegravir / cobicistat / TDF / emtricitabine), driven by Atazanavir /Reyataz () plus Truvada(TDF / emtricitabine). They were randomly assigned (2: 1) to remain in this therapeutic regimen or switch to Genvoya (elvitegravir / cobicistat / TDF / emtricitabine).
The International AIDS Society Conference last summer reported in a survey that in 48 weeks, participants who joined Genvoya were significantly better able to maintain virologic suppression and had significant improvements in bone mineral density (BMD) of the spine and hip and markers of renal function.
Tenofovir DF switching to TAF: Dr De Jesus reported that in 96 weeks, both schemes remained highly effective, but Genvoya had a statistically significant advantage edgea
Dr De Jesus reported that in 96 weeks, both schemes remained highly effective, but Genvoya had 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%).
A Editor'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 view, 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 again Genvoya had an advantage: 0,9% in the users of the TAF therapy group who had stopped treatment due to adverse events compared to 2,5% in the TDF group.
Spinal bone density increased 2,0% in TAF switches and decreased -0,3% in the group that followed the continuation of TDF therapy; the hip bone density increased by 2,1% and fell by -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 discontinuation in the TAF group (acute kidney injury and interstitial nephritis tubule) and five in the TDF group (chronic kidney disease, Fanconi's syndrome, renal colic and two cases of elevated creatinine levels in the blood).
Tenofovir DF for TAF associated with worse blood lipid results
However, the TAF group had the worst blood lipid results. Tenofovir is known to reduce lipid levels and the lower concentration of TAF had a lower effect than those that remained in the TDF regimen.
The levels of fasting lipids were higher in the TAF group than in the TDF group and 8% vs 5% started lipid-lowering drugs.
"Patients who have changed to [Genvoya] from a TDF-based regimen were significantly more likely to maintain success in virological suppression "and" had significant improvements in the spine and hip of the BMD; have 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 of the University of Alabama at Birmingham and colleagues seemed in bone loss among people on therapy with tenofovir. His poster 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 who have changed from TDF-containing schemes to Genvoya in the same study.
In addition to the previously reported gains in bone density and bone density, the mean PTH levels decreased after discontinuation for Genvoya, while levels in the TDF group decreased. The biomarkers of bone turnover decreased significantly in the group where the interruption occurred.
"These data suggest that switching from TDF to TAF can be associated with reduced risk of osteoporosis and fracture as well as long-term frailty," the researchers concluded - an important consideration in groups such as people living with HIV more and require a greater amount of ART.
Finally, 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 Huhn team, 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 females, blacks, 50 years of age or older, CD4 <200 cells / mm³, abnormal blood lipids, high blood pressure, diabetes, use of NSAIDs ( non-steroidal anti-inflammatory drugs), and clinical or subclinical renal impairment of adverse events at baseline; group had zero or one factor. A total of 323 people who switched from TAF and 168 who remained on TDF regimens were considered to be at high risk.
Outcomes of interest included incident or new cases of Chronic Renal Disease, defined as eGFR <60 ml / min among people who started with > 60; cessation of drug use due to adverse events related to Kidneys; and changes in urine renal protein including biomarkers and albumin, and retinol binding to protein and creatinine as well as to beta-2-macroglobulin-to-creatinine ratios.
Incidence of CKD developed in 2% of TAF switches and 3% of patients who continued with the TDF formulation considered to be at high risk - was not a significant difference. Among those considered low risk for DRC, 1% of TAF switches and 2% who stayed in TDF developed DRC, which has reached statistical significance. In the high-risk category two TAF switches and two TDF users discontinue use of these co-formulations due to adverse events linked to renal failure, as did three users of low-risk but not low-risk TDF Allegiant all the "translation resources I know on the Internet none gave me anything other than Allegiant to translate Allegiant - I will remain in the search, but, for now, impossible). A single high-risk patient who remained in the TDF study 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 Genvoya "With a low incidence of CKD," had no dropout due to tubulopathic renal insufficiency*, and saw significant reductions in proteinuria and tubular proteinuria.
Tenofovir DF to TAF:
"These results demonstrate the durable effectiveness and improved safety of kidney Genvoya  as a switch scheme for adults with underlying risk for CKD, "he concluded.
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 to filter out waste, salts and blood fluids. When this happens, the waste can reach dangerous levels and affect the chemical makeup of your 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, in a site in Portuguese)
Translated by Claudio Souza from the original in English on the link Switching to new tenofovir alafenamide keeps virus in check and Improves kidney and bone health
Reviewed by Mara Macedo
Originally posted at: 11 July 2011 and 18 July 2016
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