Real-world impact of switching from tenofovir disoproxil fumarate to tenofovir alafenamide

Article Details

Authors
Sarah M Michienzi, Mikayla Johnson, Thomas D Chiampas, Eric Wenzler, Rodrigo M Burgos, Renata O Smith, Melissa E Badowski

Article Type
Original Research

DOI
10.7573/dic.2021-2-1

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Abstract

Although tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) have been evaluated in various clinical trials, limited safety and efficacy data exist in real-world settings. The goal of this retrospective analysis is to assess changes in virological suppression, immunological status, renal function, weight and body mass index (BMI) amongst people living with HIV who switched from a TDF-based to a TAF-based regimen. Of 130 patients included in the final analysis, 53 patients experienced an increase in their viral load upon switching from TDF to TAF therapy whilst 62 patients remained undetectable. For those who experienced a viral blip, 33 (62%) resuppressed by the time of last follow-up, 15 (28%) patients did not have additional labs beyond the last follow-up and concern for failure occurred in 5 (9%) patients. No differences in immunological function, renal function, weight or BMI were observed from before switching to the last follow-up. Although a loss of virological suppression was found upon switching to TAF at subsequent follow-up visits, resuppression ultimately occurred in most patients.

Keywords: antiretroviral, HIV, reverse transcriptase inhibitor, switch, tenofovir.

Citation: Michienzi SM, Johnson M, Chiampas TD, Wenzler E, Burgos RM, Smith RO, Badowski ME. Real-world impact of switching from tenofovir disoproxil fumarate to tenofovir alafenamide. Drugs Context. 2021;10:2021-2-1. https://doi.org/10.7573/dic.2021-2-1

Contributions: MEB, RMB, TDC, SMM, ROS and EW conceived the presented idea and designed the study. EW conducted preliminary data analyses. MJ conducted an additional data analysis under the guidance of MEB, and SMM, MEB, MJ and SMM wrote the manuscript. All authors discussed the results and approved the final manuscript prior to submission. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: TDC obtained employment at Gilead Sciences, Inc. as a medical scientist in May 2020. RMB, SMM and ROS are investigators in a Merck-sponsored study. RMB, MJ and SMM are investigators in a Moderna-sponsored study. RMB is an investigator in a Janssen-sponsored study. EW serves on the speaker’s bureau for Melinta Therapeutics, Astellas Pharma and Allergan Plc. and on the advisory board for GenMark Diagnostics and Shionogi. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/06/dic.2021-2-1-COI.pdf

Acknowledgements: The authors thank the following individuals for their assistance with key aspects of the project: Dr Kristen Bunnell for contributing to study design and creating the project REDCap and Dr Taylor McDonald and Mr Timothy Hammer for data collection. Results from this study were presented in poster format at the 2018 American College of Clinical Pharmacists Global Conference on Clinical Pharmacy in Seattle, WA, USA (October 2018) and the 29th European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (April 2019).

Funding declaration: The use of REDCap (Research Electronic Data Capture) electronic data capture tools hosted by the University of Illinois at Chicago Center for Clinical and Translation Science for this project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR002003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Copyright: Copyright © 2021 Michienzi SM, Johnson M, Chiampas TD, Wenzler E, Burgos RM, Smith RO, Badowski ME. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Michienzi SM, Johnson M, Chiampas TD, Wenzler E, Burgos RM, Smith RO, Badowski ME. https://doi.org/10.7573/dic.2021-2-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://drugsincontext.com/real-world-impact-of-switching-from-tenofovir-disoproxil-fumarate-to-tenofovir-alafenamide

Correspondence: Melissa Badowski, Section of Infectious Diseases Pharmacotherapy, Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy, 833 S. Wood Street, Room 164, M/C 886, Chicago, IL, USA, 60612. Email: badowski@uic.edu

Provenance: Invited; externally peer reviewed.

Submitted: 2 February 2021; Accepted: 9 June 2021; Publication date: 23 July 2021.

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