Genvoya (with elvitegravir, cobicistat and emtricitabine)
Odefsey (with emtricitabine and rilpivirine)
Descovy (with emtricitabine)
|Elimination half-life||0.51 hours|
|Excretion||Feces (31.7%), urine (<1%)|
|Chemical and physical data|
|Molar mass||476.466 g/mol|
|3D model (JSmol)|
Tenofovir alafenamide (INN/USAN; trade name Vemlidy) is a nucleotide reverse transcriptase inhibitor and a prodrug of tenofovir. It was developed 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 fumarate (TDF), TAF has greater antiviral activity and better distribution into lymphoid tissues than that agent. Gilead was awarded FDA approval in November 2016 for the drug Vemlidy.
Gilead announced a phase 3 clinical trial evaluating a single-tablet regimen combining tenofovir alafenamide with cobicistat, emtricitabine and elvitegravir and developed a coformulation of the drug with cobicistat, emtricitabine and the protease inhibitor darunavir. In a 48-week study comparing elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil (trade name Stribild) 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. The FDA approved the TAF-based treatment regimen for treatment of HIV-1 in November 2015. Genvoya is the first TAF-based regimen to receive approval.
Fixed-dose combinations containing tenofovir alafenamide
- Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (trade name Genvoya) — approved November 5, 2015 (compare Elvitegravir/cobicistat/emtricitabine/tenofovir; trade name Stribild)
- Emtricitabine/rilpivirine/tenofovir alafenamide (trade name Odefsey) — approved March 1, 2016 (compare Emtricitabine/rilpivirine/tenofovir; trade name Complera)
- Emtricitabine/tenofovir alafenamide (trade name Descovy) — approved April 4, 2016 (compare Emtricitabine/tenofovir; trade name Truvada)
- Sofosbuvir — an HCV RNA polymerase (NS5B) inhibitor bearing structural similarity (phosphoramidate side chain metabolized by cathepsin A, carboxylesterase 1 and histidine triad nucleotide-binding protein 1)
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- 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
- "Gilead Initiates Phase 3 Clinical Program for Tenofovir Alafenamide" (Press release). Gilead. January 2013. Archived from the original on 2013-02-07.
- McQueen, Courtney (16 Nov 2011). "Gilead And Tibotec To Develop Single-Pill Protease Inhibitor-Based Combination Regimen". The AIDS Beacon.
- GS-7340 Packs Greater HIV Punch, Potentially Better Safety, Versus Viread Horn, Tim. 15 Mar 2012. AIDSmeds.com
- 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.
- Once-Daily Tenofovir Prodrug Combo Pill as Effective as Stribild. AIDSmeds.com 1 Nov 2012.
- CROI 2013: New Pro-drug Tenofovir Alafenamide Appears Equally Effective but Better Tolerated. Highleyman, Liz. HIVandHepatitis.com. 6 March 2013.
- Horn, T. et al. Tenefovir Alafenamide Fumarate (TAF) Sign-On Letter to Gilead. 13 June 2013. Treatment Action Group.
- "U.S. Food and Drug Administration Approves Gilead's Single Tablet Regimen Genvoya (Elvitegravir, Cobicistat, Emtricitabine and Tenofovir Alafenamide) for Treatment of HIV-1 Infection". Gilead. 5 November 2015.
- "Odefsey (emtricitabine, rilpivirine, and tenofovir alafenamide) Tablets, for Oral Use. U.S. Full Prescribing Information" (PDF). Gilead Sciences, Inc. Retrieved 2 March 2016.
- "Descovy (emtricitabine and tenofovir alafenamide) Tablets, for Oral Use. U.S. Full Prescribing Information" (PDF). Gilead Sciences, Inc. Retrieved 5 April 2016.
- "Comparison of tenofovir prodrugs: TAF vs TDF". DRUG R&D INSIGHT. Retrieved 24 November 2015.
- Murakami, E.; Tolstykh, T.; Bao, H.; Niu, C.; Steuer, H. M. M.; Bao, D.; Chang, W.; Espiritu, C.; Bansal, S.; Lam, A. M.; Otto, M. J.; Sofia, M. J.; Furman, P. A. (26 August 2010). "Mechanism of Activation of PSI-7851 and Its Diastereoisomer PSI-7977". Journal of Biological Chemistry. 285 (45): 34337–34347. doi:10.1074/jbc.M110.161802. PMC . PMID 20801890.