Improvement in bone mineral density after switching from tenofovir to abacavir in HIV-1-infected patients with low bone mineral density: two-centre randomized pilot study (OsteoTDF study) | Fundació Lluita contra la Sida

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PUBLICACIONS CIENTÍFIQUES > Improvement in bone mineral density after switching from tenofovir to abacavir in HIV-1-infected patients with low bone mineral density: two-centre randomized pilot study (OsteoTDF study)

Improvement in bone mineral density after switching from tenofovir to abacavir in HIV-1-infected patients with low bone mineral density: two-centre randomized pilot study (OsteoTDF study)

13/08/2014

Autors: Eugènia Negredo, Pere Domingo, Núria Pérez-Álvarez, Mar Gutiérrez, Gracia Mateo, Jordi Puig, Roser Escrig, Patricia Echeverría, Anna Bonjoch and Bonaventura Clotet

Revista: Journal of Antimicrobial Chemotherapy

Background: Tenofovir has been associated with a decrease in bone mineral density (BMD). However, data on changes in BMD after discontinuing tenofovir are lacking.

Methods: We performed a two-centre randomized pilot study in virologically suppressed HIV-infected patients receiving tenofovir with osteopenia/osteoporosis (OsteoTDF study, ClinicalTrials.gov number NCT 01153217). Fifty-four patientswere randomly assigned to switch from tenofovir to abacavir (n¼26) or to continue with tenofovir (n¼28). Changes in lumbar and total hip BMD were evaluated at Week 48 from baseline.

Results: Five patients discontinued the study (three from the tenofovir group and two from the abacavir group). No significant differences were detected between the groups atWeek 48 (P¼0.229 for total hip and P¼0.312 for lumbar spine). However, hip BMD improved by 2.1% (95% CI 20.6 to 4.7) (P¼0.043) in the abacavir group and 0.7% (95% CI20.9 to 2.4) (P¼0.372) in the tenofovir group. Lumbar spine BMD varied by20.7% (95% CI23.8 to 3.3) (P≤0.001) in the abacavir group and 21.2% (95% CI 23.8 to 0.4) (P,0.001) in the tenofovir group.

Conclusions: Switching from tenofovir to abacavir led to a slight improvement in femoral BMD although no differences were detected between groups. Larger studies are necessary before firm recommendations can be made on the discontinuation of tenofovir in patients with a low BMD.