Tenofovir alafenamide

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Systematic (IUPAC) name
Isopropyl (2S)-2-[[[(1R)-2-(6-aminopurin-9-yl)-1-methyl-ethoxy]methyl-phenoxy-phosphoryl]amino]propanoate
Clinical data
Trade names Genvoya (with elvitegravir, cobicistat and emtricitabine
Legal status
  • ℞ (Prescription only)
Routes of
administration		 Oral (tablets)
Pharmacokinetic data
Protein binding ~80%[1]
Biological half-life 0.51 hours
Excretion Feces (31.7%), urine (<1%)
Identifiers
CAS Number 379270-37-8
ATC code J05AR17 (WHO) J05AR18 J05AR19 (combination codes)
PubChem CID: 9574768
DrugBank DB09299
ChemSpider 7849225
UNII EL9943AG5J YesY
KEGG D10428
ChEBI CHEBI:90926 YesY
ChEMBL CHEMBL2107825
Chemical data
Formula C21H29N6O5P
Molecular mass 476.466 g/mol
  • C[C@H](CN1C=NC2=C(N=CN=C21)N)OC[P@@](=O)(N[C@@H](C)C(=O)OC(C)C)OC3=CC=CC=C3
  • InChI=1S/C21H29N6O5P/c1-14(2)31-21(28)16(4)26-33(29,32-17-8-6-5-7-9-17)13-30-15(3)10-27-12-25-18-19(22)23-11-24-20(18)27/h5-9,11-12,14-16H,10,13H2,1-4H3,(H,26,29)(H2,22,23,24)/t15-,16+,33+/m1/s1
  • Key:LDEKQSIMHVQZJK-CAQYMETFSA-N
File:Tenofovir alafenamide fumarate.svg
Tenofovir alafenamide fumarate, the salt used in drug formulations.

Tenofovir alafenamide (INN/USAN, formerly GS-7340) is a nucleotide reverse transcriptase inhibitor and a prodrug of tenofovir. It is under development by Gilead Sciences for use in the treatment of HIV infection and chronic hepatitis B, and is applied in the form of tenofovir alafenamide fumarate (TAF). Closely related to the commonly used reverse-transcriptase inhibitor tenofovir disoproxil, TAF has greater antiviral activity and better distribution into lymphoid tissues than that agent.[2][3]

Gilead announced a phase 3 clinical trial evaluating a single-tablet regimen combining tenofovir alafenamide with cobicistat, emtricitabine and elvitegravir[4] and developed a coformulation of the drug with cobicistat, emtricitabine and the protease inhibitor darunavir.[5][6][7] In a 48 week study comparing elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (trade name Genvoya), the results showed the newer drug to be noninferior to the established agent, but at much lower dosages and with lower incidence of adverse side effects such as impaired kidney function.[8][9][10] The FDA approved the TAF-based treatment regimen for treatment of HIV-1 in November 2015.[11] Genvoya is the first TAF-based regimen to receive approval.[11]

Fixed-dose combinations containing tenofovir alafenamide

  • Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (trade name Genvoya) — approved November 5, 2015
  • Emtricitabine/rilpivirine/tenofovir alafenamide (trade name Odefsey)[12] — approved March 1, 2016
  • Emtricitabine/tenofovir alafenamide (trade name Descovy)[13] — approved April 4, 2016

See also

References

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  1. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  2. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  3. ↑ M Markowitz, A Zolopa, et al. GS-7340 Demonstrates Greater Declines in HIV-1 RNA than Tenofovir Disoproxil Fumarate During 14 Days of Monotherapy in HIV-1 Infected Subjects. 18th Conference on Retroviruses and Opportunistic Infections 2 Mar 2011. Paper # 152LB
  4. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  5. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  6. ↑ GS-7340 Packs Greater HIV Punch, Potentially Better Safety, Versus Viread Horn, Tim. 15 Mar 2012. AIDSmeds.com
  7. ↑ Pharmacokinetics of a Novel EVG/COBI/FTC/GS-7340 Single Tablet Regimen. 13th International Workshop on Clinical Pharmacology of HIV Therapy. Barcelona, Spain. April 16–18, 2012.
  8. ↑ Once-Daily Tenofovir Prodrug Combo Pill as Effective as Stribild. AIDSmeds.com 1 Nov 2012.
  9. ↑ CROI 2013: New Pro-drug Tenofovir Alafenamide Appears Equally Effective but Better Tolerated. Highleyman, Liz. HIVandHepatitis.com. 6 March 2013.
  10. ↑ Horn, T. et al. Tenefovir Alafenamide Fumarate (TAF) Sign-On Letter to Gilead. 13 June 2013. Treatment Action Group.
  11. ↑ 11.0 11.1 Lua error in package.lua at line 80: module 'strict' not found.
  12. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  13. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  14. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  15. ↑ Lua error in package.lua at line 80: module 'strict' not found.
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