Is Tenofovir Alafenamide Safer than Tenofovir Disoproxil Fumarate for the Kidneys?
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Aloy B, Tazi I, Bagnis CI, Gauthier M, Janus N, Launay-Vacher V, Deray G, Tourret J
Is Tenofovir Alafenamide Safer than Tenofovir Disoproxil Fumarate for the Kidneys?
AIDS Rev. 2016 Oct-Dec;18(4):184-192.
- PubMed ID
- 27438578 [ View in PubMed]
- Abstract
Tenofovir disoproxil fumarate is currently the cornerstone of HIV treatment. Although it shows an overall good safety profile, numerous cases of nephrotoxicity have been reported. Tenofovir alafenamide is a novel tenofovir prodrug that has been developed to improve renal safety. Pharmacokinetic studies suggest a better renal tolerance of tenofovir alafenamide than tenofovir disoproxil fumarate, probably because tenofovir plasma concentrations are lower after tenofovir alafenamide administration. Consistently in clinical trials, renal tolerance seems to be improved in patients treated with tenofovir alafenamide. However, some questions remain. First, whether tenofovir can accumulate and lead to nephrotoxicity under specific circumstances after tenofovir alafenamide administration is unknown. Second, only "real-world practice" will inform us on the long-term renal safety of tenofovir alafenamide. Last, tenofovir alafenamide renal safety in patients with chronic kidney disease has not been studied in any randomized clinical trial. In conclusion, tenofovir alafenamide appears as a very promising drug and long-term safety will be an important determinant of its expanded use.
DrugBank Data that Cites this Article
- Drugs
- Drug Enzymes
Drug Enzyme Kind Organism Pharmacological Action Actions Tenofovir alafenamide Liver carboxylesterase 1 Protein Humans NoSubstrateDetails Tenofovir alafenamide Lysosomal protective protein Protein NoSubstrateDetails - Drug Transporters
Drug Transporter Kind Organism Pharmacological Action Actions Tenofovir Multidrug resistance-associated protein 4 Protein Humans NoSubstrateDetails Tenofovir Solute carrier family 22 member 6 Protein Humans NoSubstrateDetails Tenofovir Solute carrier family 22 member 8 Protein Humans NoSubstrateDetails Tenofovir alafenamide Multidrug resistance-associated protein 4 Protein Humans NoSubstrateDetails Tenofovir alafenamide P-glycoprotein 1 Protein Humans UnknownSubstrateDetails Tenofovir alafenamide Solute carrier family 22 member 6 Protein Humans NoSubstrateDetails Tenofovir alafenamide Solute carrier family 22 member 8 Protein Humans NoSubstrateDetails