Browsing by Subject "Descovy"

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    Metabolic adverse effects of different HIV pre-exposure prophylaxis medications in minority populations : a United States multicenter research network propensity-matched analysis
    (2022-05-09) Yap, Alexander Gregory; Reveles, Kelly Renee; Ryan, Laurajo; Koeller, Jim
    Purpose: To evaluate the association between human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) formulations and their metabolic side effects in a national sample of United States (U.S.) hospital systems and side effect disparities by race and ethnicity. Methods: This retrospective cohort study utilized the TriNetX research database to compare emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) or FTC/tenofovir alafenamide (TAF) from October 2019 to February 2022. Males 18 years or older exposed to either FTC/TDF or FTC/TAF were included. A cohort for each drug was compiled and analyzed for all races/ethnicities, Black-only patients, and Hispanic-only patients. The index event was first exposure to FTC/TDF or FTC/TAF. Screening for baseline characteristics was performed from one year prior to index date up until inclusion. Propensity score matching was performed by demographics and key comorbidities and medications associated with metabolic syndrome and weight gain. Outcomes included documented BMI >30kg/m², diagnoses of metabolic disease, and medications associated with treatment of metabolic disease. Results: Overall, 9856 patients were included for analysis (4978 patients per arm). Patients were predominantly White (40.8% in FTC/TAF and 56.1% in FTC/TDF) and overweight (BMI 27 kg/m²) with a median age of 39 years. Black-only patients (n=1950; 975 patients in each arm) in both cohorts were a median 37 years old, 1.5% Hispanic, and had an average BMI of 27.6 kg/m². Hispanic patients in both cohorts (n=988; 494 patients in each arm) were a median 34 years old, 53% White, and had an average BMI of 27.6 kg/m². For all cohort comparisons, no differences were found in newly documented BMI >30 kg/m² or metabolic disease diagnosis. The cohort with all patients had a higher exposure rate of statins (2.6% vs 1.7%, p=0.0054), insulin (1.2% vs 0.7%, p=0.0186), and metformin (1.0% vs 0.6%, p=0.0142) in the FTC/TAF vs FTC/TDF groups. In the Hispanic-only analysis, the FTC/TDF cohort had higher exposure rates to sulfonylureas (2.0% vs 0%, p=0.0015), SGLT2 inhibitors (2.0% vs 0%, p=0.0015), and thiazides (2.0% vs 0%, p=0.0015). Conclusion: Despite growing concerns for TAF causing weight gain in HIV patients, this study did not show any differences in metabolic disease diagnoses or new documented BMI >30 kg/m² in a composite cohort and in racial/ethnic minority patients for HIV PrEP.