inPractice® - Modifying NNRTIs in Virologically Suppressed Patients

Studies examining the efficacy of switching NNRTIs in virologically suppressed patients because of toxicity found a majority of patients safely maintained virologic suppression^{[Pozniak 2014; Gulick 2006; Schouten 2010; Parienti 2007]}
STRATEGY-NNRTI study found that switching virologically suppressed patients from NNRTI plus emtricitabine/tenofovir DF to single-tablet, once-daily cobicistat/elvitegravir/emtricitabine/tenofovir DF was well-tolerated and noninferior to continuing NNRTI-based therapy at Week 48 (Capsule Summary)^{[Pozniak 2014]}
Study 109 showed that switching from tenofovir DF–containing ART regimen to cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide was associated with significantly higher rate of maintained virologic suppression, including in subset of patients receiving efavirenz/emtricitabine/tenofovir DF at baseline, and significant improvements in bone health and proximal tubular function endpoints at Week 48 vs continuing tenofovir DF–containing ART^{[Mills 2016]}