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Changes in bone quality after switching from a TDF to a TAF based ART: a pilot randomized study

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dc.contributor.author Soldado-Folgado, Jade
dc.contributor.author Rins-Lozano, Oriol
dc.contributor.author Arrieta Aldea, Itziar
dc.contributor.author González Mena, Alicia
dc.contributor.author Cañas-Ruano, Esperanza
dc.contributor.author Knobel Freud, Hernando
dc.contributor.author Garcia Giralt, Natàlia
dc.date.accessioned 2023-09-18T06:24:34Z
dc.date.available 2023-09-18T06:24:34Z
dc.date.issued 2023
dc.identifier.citation Soldado-Folgado J, Rins-Lozano O, Arrieta-Aldea I, González-Mena A, Cañas-Ruano E, Knobel H, Garcia-Giralt N, Güerri-Fernández R. Changes in bone quality after switching from a TDF to a TAF based ART: a pilot randomized study. Front Endocrinol. 2023;14:1076739. DOI: 10.3389/fendo.2023.1076739
dc.identifier.issn 1664-2392
dc.identifier.uri http://hdl.handle.net/10230/57902
dc.description.abstract Background: The impact of tenofovir disoproxil fumarate (TDF) antiretroviral (ART) regimens on bone health has been characterized mostly by bone mineral density (BMD), but recently also by bone quality (BQ). The aim of this pilot study is to assess the changes in BMD and BQ after switch from TDF to tenofovir alafenamide (TAF) ART. Methods: HIV individuals receiving TDF-based ART were randomized to switch to Bictegravir-TAF-Emtricitabine or to remain in the same regimen. At baseline and 24-weeks after randomization, participants underwent bone mineral density (BMD) by DXA and BQ assessment using bone microindentation, a validated technique that measures bone tissue quality expressed as bone material strength index (BMSi). A panel of plasma bone turnover biomarkers were measured by ELISA at the same time-points. Values are expressed as median [interquartile range] and non-parametric tests were used where appropriate. Results: A total of 24 HIV individuals were included in the study, 19 of which were men (80%). Median age at baseline was 43 years (IQR 38-54). Half of individuals were allocated in the TDF group while the other half changed to TAF treatment. No differences at baseline between both groups were detected in any parameter. Non-significant changes nor in lumbar or femoral BMD at week 24 was found in any regimen. In contrast, there was an increase in BMSi in the TAF arm at 24 weeks, and thus an improvement in BQ[81.6 (79-83) to 86 (80-88) (+5.1%);p=0.041], whereas the TDF arm remained stable from 82 (76-85) at baseline to 82 (73-83);p=0.812. Hence, at week 24 there were significant differences in BQ between arms (p=0.049). A reduction in bone formation markers was found at week 24 in both regimens: N-terminal propeptide of type-1 collagen decreased a 20% (-35 - -0.6); p=0.031 with TAF and -16% (-25 - -5); p=0.032 with TDF. Also a decrease in bone resorption marker C-telopeptide with TAF was detected [-10% (-19 - -5);p=0.028] but not with TDF (p=0.232), suggesting a less metabolically active bone after switching to TAF. Conclusion: A bone quality improvement was found after switching from a TDF to a TAF based ART independently of BMD, suggesting that the bone health benefits of TAF may extend beyond BMD. Future research should be directed to confirm these findings and to identify the underlying mechanisms of ART related bone toxicity.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Frontiers
dc.relation.ispartof Front Endocrinol. 2023;14:1076739
dc.rights © 2023 Soldado-Folgado, Rins-Lozano, Arrieta-Aldea, González-Mena, Cañas-Ruano, Knobel, Garcia-Giralt and Güerri-Fernández. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Changes in bone quality after switching from a TDF to a TAF based ART: a pilot randomized study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3389/fendo.2023.1076739
dc.subject.keyword HIV infection
dc.subject.keyword Antiretroviral therapy
dc.subject.keyword Bone quality
dc.subject.keyword Fracture risk
dc.subject.keyword Microindentation
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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