Descovy: The new era of HIV prevention

Descovy: The new era of HIV prevention
Anh Nguyen, PharmD, Walgreens / Bethesda Family Medicine Clinic 

Although healthcare has made tremendous strides throughout the years, over 38,000 people were diagnosed with human immunodeficiency virus (HIV) in 2017. Since the discovery of HIV in the early 1980s, several HIV treatments have come out on the market, however, only TruvadaTM has been indicated for HIV prevention, until now. Recently in October of 2019, the U.S. Food and Drug Administration (FDA) approved Descovy™ as pre-exposure prophylaxis (PrEP) to reduce the risk of acquiring HIV type 1 (HIV-1). Descovy™ is only FDA approved for adults and adolescents weighing > 35 kg and excludes individuals at risk of HIV-1 infection from receptive vaginal sex.

In a randomized, double-blinded multinational trial in 5,387 HIV-negative men and transgender women, the rate of HIV-1 infection was similar between participants who were taking Descovy ™ with those who were taking TruvadaTM.. Both Descovy ™ and TruvadaTM contain emtricitabine. However, Descovy ™ also contains tenofovir alafenamide while TruvadaTM contains tenofovir disoproxil fumarate. The tenofovir disoproxil fumarate component in TruvadaTM has more side effects as well as renal adjustments with CrCl < 50 ml/min and more long-term bone demineralization than Descovy ™ which only warrants discontinuation at CrCl < 30 ml/min. Both medications have a black box warning for exacerbating hepatitis B (HBV) infections in people infected with HBV.

Descovy’s™ new FDA indication expands HIV prophylaxis to a much wider patient population such as those with renal dysfunction like our elderly population and patients who could not tolerate TruvadaTM side effects. With this new expansion, we’ve stepped into a new era of HIV prevention that can help lead us to defeat the HIV epidemic.

References:

  1. Moss JA. HIV/AIDS Review.Radiol Technol. 2013;84(3):247-67.

  2.  FDA approves second drug to prevent HIV infection as part of ongoing efforts to end the HIV epidemic [News Release]. U.S. Food and Drug Administration.2019.https://www.fda.gov/news-events/press-announcements/fda-approves-second-drug-prevent-hiv-infection-part-ongoing-efforts-end-hiv-epidemic

  3. Emitriciabine/tenofovir alafenamide. Micromedex Solutions. Truven Health Analytics, Inc. Ann Arbor, MI. Available athttp://www.micromedexsolutions.com. Accessed November 14, 2019.

  4. Emitriciabine/tenofovir disoproxil fimarate. Micromedex Solutions. Truven Health Analytics, Inc. Ann Arbor, MI. Available athttp://www.micromedexsolutions.com. Accessed November 14, 2019.