2015
DOI: 10.3851/imp3000
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Effects on Vitamin D, Bone and the Kidney of Switching from Fixed-Dose Tenofovir Disoproxil Fumarate/Emtricitabine/Efavirenz to Darunavir/ Ritonavir Monotherapy: A Randomized, Controlled Trial (MIDAS)

Abstract: Switching from TDF/FTC/EFV to DRV/r in patients with suppressed HIV RNA resulted in significant improvements in 25(OH)D and bone biomarkers, and a 2-3% increase in BMD.

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Cited by 23 publications
(26 citation statements)
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“…Biomarkers of bone turnover were also significantly lower among patients receiving TAF at week 48 compared to patients receiving TDF . There have also been several case reports of improvement of proximal renal tubular function in CHB patients who were switched from TDF to TAF …”
Section: Discussionsupporting
confidence: 59%
See 1 more Smart Citation
“…Biomarkers of bone turnover were also significantly lower among patients receiving TAF at week 48 compared to patients receiving TDF . There have also been several case reports of improvement of proximal renal tubular function in CHB patients who were switched from TDF to TAF …”
Section: Discussionsupporting
confidence: 59%
“…This finding is clinically relevant given progressively ageing cohort of CHB patients worldwide and particularly the propensity of Asian CHB patients developing osteoporosis as a normal part of senescence . Similar increase in BMD was seen 48 weeks after switching from a TDF‐containing regimen to a TAF‐containing regimen or non–tenofovir‐based anti‐viral therapy among HIV‐infected patients . Taken together, these observations suggest that BMD caused by TDF is reversible.…”
Section: Discussionmentioning
confidence: 99%
“…Table 2 displays switch studies that evaluated BMD change after switches from TDF to non-TDF containing regimens (3739). Prior to the recently reported TAF switch study (40; described in a subsequent section in this review), the studies were small.…”
Section: Tenofovir Disoproxil Fumarate: Clinical Datamentioning
confidence: 99%
“…Forty-eight weeks after the switch, individuals had a significant increase in BMD from baseline of 3.0% and 2.5% at the lumbar spine and hip, respectively. Finally, the MIDAS Study randomized 64 individuals on efavirenz/emtricitabine/TDF to continued therapy versus a switch to darunavir/ritonavir monotherapy (39). At 48 weeks, individuals randomized to darunavir/ritonavir had a statistically significant improvement in BMD at both the lumbar spine and femoral neck compared to those individuals maintained on their baseline TDF-containing therapy (Lumbar spine change: 0.0% vs. +2.6%; p<0.001; Femoral neck change: 0.0% vs. +2.9%, p<0.001), suggesting that the BMD decrease with TDF initiation may be largely reversible.…”
Section: Tenofovir Disoproxil Fumarate: Clinical Datamentioning
confidence: 99%
“…Virologically suppressed patients in the Monarch RCT substudy who were randomized to DRV/r monotherapy experienced an increase in spine and hip BMD compared with those who were maintained on a 2NRTI + DRV/r regimen [45*]. Similarly, results from the MIDAS study demonstrate an improvement in BMD in patients switched from TDF/FTC/EFV to DRV/r monotherapy [46*]. Similar results were seen in a nonrandomized study in which cART experienced, virologically suppressed patients on a PI/r based regimen containing TDF were switched from TDF to RAL [50].…”
Section: The Bone Effects Of the Hiv Protease Inhibitorsmentioning
confidence: 99%