Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP

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Presentation transcript:

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP

Switch ZDV-3TC to TDF-FTC Switch ZDV-3TC to ABC-3TC Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Cardiovascular Biomarkers): Study Design Study Design: SWAP (Cardiovascular) Background: Open-label, randomized trial examining cardiovascular biomarkers in virologically suppressed patients switching from ZDV-3TC to TDF-FTC or ABC-3TC Inclusion Criteria - Adults with HIV infection - Receiving cART that includes ZDV-3TC - Undetectable HIV RNA for >12 weeks - No previous use of ABC or TDF - HLA-B*5701-negative - No diabetes mellitus or untreated HTN Treatment Arms - Switch ZDV-FTC to TDF-FTC - Switch ZDV-FTC to ABC-3TC Switch ZDV-3TC to TDF-FTC (n = 20) Switch ZDV-3TC to ABC-3TC (n = 20) Source: Rasmussen TA, et al. BMC Infect Dis. 2011;11:267.

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Cardiovascular Biomarkers): Results Week 48: Change in Cardiovascular Biomarkers from Baseline Source: Rasmussen TA, et al. BMC Infect Dis. 2011;11:267.

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Cardiovascular Biomarkers): Results Week 48: Change in Plasma Lipids from Baseline P = 0.002 P = 0.117 P = 0.002 P = 0.121 Source: Rasmussen TA, et al. BMC Infect Dis. 2011;11:267.

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Cardiovascular Biomarkers): Conclusions Conclusion: “In patients randomized to abacavir-based HIV-treatment transient increases were seen in the plasma levels of E-selectin and sVCAM-1 compared with treatment with tenofovir, but no difference between study arms was found in other biomarkers associated with endothelial dysfunction, inflammation, or coagulation. The clinical significance of these findings is uncertain.” Source: Rasmussen TA, et al. BMC Infect Dis. 2011;11:267.

Switch ZDV-3TC to TDF-FTC Switch ZDV-3TC to ABC-3TC Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Bone and Renal Effects): Study Design Study Design: SWAP (Bone and Renal) Background: Open-label, randomized trial examining bone and renal effects of switching ZDV-3TC to TDF-FTC- or ABC-3TC in virologically suppressed patients Inclusion Criteria: - Adults with HIV infection - Receiving cART that includes ZDV-3TC - Undetectable HIV RNA for >12 weeks - No previous use of ABC or TDF - HLA-B*5701-negative - No diabetes mellitus or untreated HTN Treatment Arms: - Switch ZDV-FTC to TDF-FTC - Switch ZDV-FTC to ABC-3TC Switch ZDV-3TC to TDF-FTC (n = 20) Switch ZDV-3TC to ABC-3TC (n = 20) Source: Rasmussen TA, et al. PLoS One. 2012;7:e32445.

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Bone and Renal Effects): Study Design Week 48: Change in Bone Mineral Density from Baseline P = 0.006 P = 0.003 Source: Rasmussen TA, et al. PLoS One. 2012;7:e32445.

Effects of Switching ZDV-3TC to TDF-FTC or ABC-3TC SWAP (Bone and Renal Effects): Conclusions Conclusion: “Switching to TDF/FTC-based therapy led to decreases in BMD and increases in bone turnover markers compared with ABC/3TC-based treatment. No major difference in renal function was observed.” Source: Rasmussen TA, et al. PLoS One. 2012;7:e32445.