July 8, 2002
Since the approval of tenofovir, there has been interest in the potential for its use in a variety of clinical settings. While the initial studies used it in addition to a "failing" regimen, there has also been interest in its role as a substitute for a drug in a regimen that is no longer tolerated. This poster reviewed the outcomes of a variety of clinical uses at a large and successful practice in Orlando, Florida.
In this study, the authors reported on the outcomes of 231 patients. Most of the patients added tenofovir in a "standard" manner, e.g. added to a regimen that was not suppressive. However, about 60 patients used tenofovir as a substitute for another drug for which there were side effects. Of these, the majority were patients experiencing peripheral neuropathy while on stavudine (Zerit). Seventy-three percent of the patients with peripheral neuropathy improved after the change to tenofovir while also maintaining viral suppression. A few switched from stavudine because they were experiencing lipoatrophy and there was some suggestion of improvement in about 30 percent of these patients over the short time of follow up. Another way tenofovir was used was to simplify a regimen -- about 45 patients used tenofovir to replace another drug in their regimen in order to simplify the entire regimen, as tenofovir is taken as one pill once daily. Again, all patients maintained viral control.
Clearly, all the potential uses for tenofovir are still being explored. For those currently on a regimen that is virologically successful but otherwise difficult -- either for reasons of toxicity or complexity -- this study would suggest that tenofovir can be considered for use as a substitute for other agents, and that it will improve on both of these challenges while still maintaining control of HIV.
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