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J Antimicrob Chemother. 2014 Dec;69(12):3368-71. doi: 10.1093/jac/dku300. Epub 2014 Aug 13.

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).

Author information

1
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain.
2
Santa Creu i Sant Pau Hospital, Barcelona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain.
3
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain Statistics and Operations Research Department, Universitat Politècnica de Catalunya, Barcelona, Spain.
4
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain abonjoch@flsida.org.
5
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain Universitat Autònoma de Barcelona, Barcelona, Spain Irsicaixa Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain.

Abstract

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 patients were randomly assigned to switch from tenofovir to abacavir (n = 26) or to continue with tenofovir (n = 28). 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 at Week 48 (P = 0.229 for total hip and P = 0.312 for lumbar spine). However, hip BMD improved by 2.1% (95% CI -0.6 to 4.7) (P = 0.043) in the abacavir group and 0.7% (95% CI -0.9 to 2.4) (P = 0.372) in the tenofovir group. Lumbar spine BMD varied by -0.7% (95% CI -3.8 to 3.3) (P ≤ 0.001) in the abacavir group and -1.2% (95% CI -3.8 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.

KEYWORDS:

DXA scan; HIV-infected patients; osteoporosis; virologically suppressed

PMID:
25125679
DOI:
10.1093/jac/dku300
[Indexed for MEDLINE]

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