Renal and Bone Over Time

HIV prevention with the long term in mind1-4

The duration of PrEP medication therapy can be unpredictable

Some individuals take PrEP medications for extended periods of time, as their HIV risk persists.

In one study analyzing data from patients who received PrEP medication prescriptions at a Boston health center between 1/1/12 and 12/31/15, and who had ≥3 years of follow-up, almost half had an active prescription for >3 years*

Patterns of PrEP medication persistence (n=1402)

Chart showing patterns of PrEP medication persistence.

*This study does not include DESCOVY FOR PrEP® users. DESCOVY® was approved for use in prevention in October 2019.

When prescribing a potential long-term drug, such as a PrEP medication, consider the following:

  • Renal function may change over time

  • Bone density is crucial for individuals of any age

Renal function may decline over time due to age and other factors5-11

Markers of renal function that can be affected by exposure to certain drugs include

  • eGFR
  • serum creatinine

Mean GFR values across life span in cisgender malesa

Graph showing mean GFR values across life span in cisgender males.

~36% of men on a PrEP medication are aged 40 and over, an age when renal function may be declining. Source: IQVIA LAAD Weekly, through October 2021.

a Chart reprinted with permission from Elsevier.

This information is an estimate derived from the use of information under license from the following IQVIA® information service: IQVIA LAAD Weekly through October 2021. IQVIA expressly reserves all rights, including rights of copying, distribution and republication.

Consider risk factors that may impact renal functionb

Bottle and glass icon.
Behavioral factors
Anabolic steroid use

Excessive alcohol consumption

Stimulant use
Bottle and glass icon.
Concomitant medications
NSAIDs
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Comorbidities
Anorexia/bulimia

CKD or declining renal function

Diabetes

Hypertension

Obesity

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Consider the long-term view when choosing a PrEP option, including impact on markers of renal function.

b Not an exhaustive list of all known renal risk factors.

Age and other factors may impact bone density9,12-14

Bone density develops through about age 30 and decreases as people age

  • <30 y/o: People under 30 may often be building bone
  • >40 y/o: People over 40 may be naturally experiencing declines in BMD

Bone mass across life span in cisgender malesa

Graph showing bone mass across life span in cisgender males.

~30% of men on a PrEP medication are aged 30 and under, and have yet to reach peak BMD.
Source: IQVIA LAAD Weekly, through October 2021.

a Adapted by permission from Springer Nature: Osteoporosis International. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations; Weaver CM, Gordon CM, Janz KF, et al; 2016.

This information is an estimate derived from the use of information under license from the following IQVIA® information service: IQVIA LAAD Weekly through October 2021. IQVIA expressly reserves all rights, including rights of copying, distribution and republication.

Consider risk factors that may impact bone mineral densityb

Bottle and glass icon.
Behavioral factors
Excessive alcohol consumption

Methamphetamine use

Smoking
Rx Icon.
Concomitant medications
Antidepressants

Proton pump inhibitors
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Comorbidities
Anorexia/bulimia

Osteoporosis/osteopenia
Exclamation point icon.

Consider the long-term view when choosing a PrEP option, including impact on BMD.

b Not an exhaustive list of all known BMD risk factors.

BMD=bone mineral density; CKD=chronic kidney disease; eGFR=estimated glomerular filtration rate; GFR=glomerular filtration rate; LAAD=Longitudinal Access and Adjudication Data; NSAID=nonsteroidal anti-inflammatory drug; WE=week ending; y/o=years old.