Infectious Disease

Study investigates PrEP use, preference in naive adults

November 23, 2022

2 min read

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Disclosures:
Elion reports being employed by Trio Health, and consulting for Gilead Sciences and ViiV. Please see study for all other authors’ relevant financial disclosures.

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Researchers evaluating new PrEP use among previously PrEP-naive patients found that patients dispensed tenofovir alafenamide had more dispenses and were less likely to switch or discontinue treatment compared with those dispensed emtricitabine/tenofovir disoproxil fumarate.

The study, which was presented at ID Week 2022, assessed the use of emtricitabine/tenofovir disoproxil fumarate (F/TDF) and tenofovir alafenamide (F/TAF) among PrEP-naive adults.

“In this study, we evaluated the utilization of F/TDF and F/TAF based PrEP-naive patients after the approval of F/TAF for PrEP in the United States,” Rick A. Elion, MD, clinical professor of medicine at George Washington University School of Medicine, said during the presentation.

In the retrospective observational study, Elion and colleagues used data from electronic medical records and dispensing information through the Trio Health HIV Research Network.

They included HIV-negative prep-naive patients who received their first dispense of daily oral PrEP between October 2019 and May 2021. Patients were followed for at least 6 months.

Among 1,330 patients who were started on PrEP, 86% were dispensed F/TAF and 14% were dispensed F/TDF.

Elion and colleagues determined that although the proportion of days covered was similar in both treatment groups, patients who took F/TAF had a higher number of dispenses and mean days supplied compared with those who took F/TDF, and mean follow-up days were similar in both groups.

Additionally, they found that patients dispensed F/TAF had longer time to regimen discontinuation, with a mean of 20.2 months compared with 8.5 months in patients dispensed F/TDF.

They also found that a higher proportion of PrEP-naive patients discontinued treatment on F/TDF (46%) compared with F/TAF (24%), and more patients switched treatment after initially being dispensed F/TDF (26%) compared with F/TAF (2%)

In additional analyses, Elion and colleagues determined that F/TDF was associated with an increased risk for switching or discontinuing PrEP (HR = 4.9; 95% CI, 3.9-6.2).

During the presentation, Elion said that older age — 25 years or older — was the “primary driver” of increased proportion of days covered.

Elion noted that the study “conclusion is that these PrEP-naive adults dispensed F/TAF, instead of F/TDF, had a great number of dispenses, mean days’ supply, and were less likely to discontinue or switch their regimen compared to patients on TDF.”

He added that “additional analyzes would include looking at people who start and stop, since there’s a great number of patients who do PrEP in sort of cycles, based on their need and risk profile, and we hope to conduct future studies looking at that issue .”

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