Evaluating Switching to Descovy from Truvada

[Jim Allen]

Interesting read perhaps for people considering switching.

Jim

More Evidence That Updated Tenofovir Is Safer to Bones and Kidneys
https://www.poz.com/article/evidence-updated-tenofovir-safer-bones-kidneys

Gilead Presents Results from Phase 3 Studies
http://www.gilead.com/news/press-releases/2016/10/gilead-presents-results-from-phase-3-studies-evaluating-switching-to-descovy-ftctafbased-regimens-from-truvada-ftctdfbased-regimens

In Study 1089, 663 virologically suppressed, HIV infected adults were randomized to switch to regimens containing Descovy or continue on regimens containing Truvada, while remaining on the same third agents. At Week 96, virologic suppression (HIV-1 RNA <50 c/mL) was maintained in 89 percent of participants in both groups (difference in percentages: -0.5 percent; 95 percent CI: -5.3 percent to 4.4 percent). Drug-related serious adverse events were rare (Descovy (FTC/TAF)-based regimens, 0 percent; Truvada (FTC/TDF)-based regimens, 0.3 percent) and drug discontinuation due to adverse events was low for both treatment groups (Descovy (FTC/TAF)-based regimens, 2.4 percent; Truvada (FTC/TDF)-based regimens, 1.2 percent). The most commonly reported adverse events included upper respiratory tract infection, diarrhea and nasopharyngitis.

In the same study, the effect of the two regimens on laboratory parameters of kidney and bone health was investigated. Statistically significant differences were observed in mean changes from baseline to Week 96 in bone mineral density (BMD) between patients receiving Descovy (FTC/TAF)-based regimens compared to patients receiving Truvada (FTC/TDF)-based regimens (spine: 2.15 percent vs. -0.17 percent; hip: 1.85 percent vs. -0.33 percent; p<0.05 for both). Additionally, more patients receiving Descovy (FTC/TAF)-based regimens experienced a greater than three percent improvement in BMD from baseline to Week 96, compared with those receiving Truvada (FTC/TDF)-based regimens (spine: 40 percent vs. 18 percent; hip: 29 percent vs. 11 percent; p<0.05 for both).

Differences favoring regimens containing Descovy were also observed in multiple tests of renal laboratory parameters which included median changes from baseline to Week 96 in estimated glomerular filtration rate (eGFR; +10.00 mL/min vs. +4.00 mL/min; p<0.05) and median percent changes in: urine protein-to-creatinine ratio (-26.0 percent vs. +2.7 percent; p<0.05); urine albumin-to-creatinine ratio (+3.4 percent vs. +27.0 percent; p<0.05); urine retinol binding protein-to-creatinine ratio; (-4.1 percent vs. +42.6 percent; p<0.05); and urine beta-2 microglobulin-to-creatinine ratio (-29.7 percent vs. +46.8 percent; p<0.05). There were no cases of Fanconi syndrome. Additionally, there were no cases of proximal renal tubulopathy in the Descovy (FTC/TAF)-based regimens group, and one case in the Truvada (FTC/TDF)-based regimens group through Week 96.

[wolfter]

I can add annedecotal thoughts.  I made the switch (previous topic here) I will never underestimate the importance that Truvada played in my survival.  I had 2 severe issues with my regimen that could never be solved.  Insomnia and diarhea.  We did differnt things incuding changing me back to Norvir

Got so bad that I switched back.  Once Descovy became available, my dr suggested a change due to my bone issues.  Don't know how that's going and that's fine.  But what I noticed with Descovy is that I actually get tired at night (normal) and fall and stay asleep. 

I now have tooting issues that I never had with Truvada.  I'm slowly getting close to tooting without siiting on my master's throne.  Been having regular bowell movements for the first time in ages.  Still rolle up a paper towell thought.  Only some will get that.