eGFR-EPI changes among HIV patients who switch from F/TDF to F/TAF while maintaining the same third agent in the Spanish VACH cohort

Abstract

Background: Evidence from clinical practice on the effects of switching from emtricitabine/tenofovir disoproxil fumarate (F/TDF) to emtricitabine/tenofovir alafenamide (F/TAF)-based triple-therapy (TT) regimens on renal parameters is limited.

Objective: This retrospective analysis evaluated the effects on renal function of switching from F/TDF to F/TAF-based TT regimens with no change in third agent among people living with HIV (PLWH).

Methods: Data were from a multicenter Spanish PLWH cohort. Patients with a baseline estimated glomerular filtration rate (eGFR-EPI) measurement, ≥1 follow-up measurement, ≥30 days treatment with F/TAF, and who switched from F/TDF to F/TAF with no change in third agent were included. Multivariate mixed linear models were used to evaluate change from baseline over time in eGFR-EPI. eGFR-EPI changes before and after switch were analyzed in a matched patient subgroup.

Results: Overall, 340 patients were included. Mean (95% CI) eGFR-EPI in patients with baseline eGFR-EPI <90 ml/min/1.73m² (n = 125) was 79.6 (78.0; 81.2) ml/min/1.73m² at baseline and 81.3 (79.9; 82.7) ml/min/1.73m² at 12 months after switch. In the patient-matched subgroup (n = 175), median annual eGFR-EPI declined −4.24 ml/min/1.73m² while on F/TDF and increased +0.93 ml/min/1.73m² after switch to F/TAF (P < 0.0001). In patients with baseline eGFR-EPI <90 ml/min/1.73m², median annual eGFR-EPI increased +4.19 mL/min/1.73m² after switch (P < 0.0001).

Conclusion: Switching from F/TDF to F/TAF-based TT regimens while maintaining the same third agent numerically improved eGFR-EPI in PLWH with baseline eGFR-EPI <90 mL/min/1.73m². eGFR-EPI improved significantly when comparing progression while on F/TDF vs progression after switch, confirming beneficial renal effects of switching to F/TAF in a clinical practice setting.

Keywords:

• HIV
• estimated glomerular filtration rate
• emtricitabine
• tenofovir disoproxil fumarate
• tenofovir alafenamide
• switch
• retrospective

Acknowledgments

This research was funded by Gilead Sciences Europe, Ltd. Medical writing and editorial assistance were provided by Erin P. Scott, PhD, of Maple Health Group and was funded by Gilead Sciences Europe, Ltd.

Disclosure statement

R. Teira, J. Muñoz, P. Galindo, M.D. Merino, B. de la Fuente, M.A. Sepúlveda, P. Domingo, J. García, M. Castaño, E. Ribera, P. Geijo A. Romero, J. Peraire, E. deig, B. Roca, E. Martínez, V. Estrada, M. Montero, J. Berenguer and N. Espinosa declare at least one of the following: having performed consultancy, or having received research grants, or having received financial compensation for scientific talks, or having collaborated in the preparation of educational material, or having received travel grants for attending scientific congresses, from at least one of the following: Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag, MSD, ViiV Healthcare o AbbVie. H. Diaz-Cuervo is a Gilead Sciences Europe, Ltd employee, F. Aragão received consultancy fees from Maple Health Group, LLC, a company hired by Gilead Sciences Europe, Ltd to perform the analysis.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, RT. The data are not publicly available due to restrictions [e.g. their containing information that could compromise the privacy of research participants].

Additional information

Funding

Research funded by Gilead Sciences Europe, Ltd. Gilead Sciences contributions to the research are expressed in HDC contributions (Collaboration in study design, and interpretation of results and writing of the paper). Gilead Sciences Europe, Ltd also held the final decision to publish.