i. Fewer adverse effects on bone density and renal function.
ii. Most patients should be switched from Viread to Vemlidy given the most favorable side effect profile.
iii. Vemlidy and Viread are similar in terms of efficacy, however, Vemlidy achieves similar results to Viread at a dose less than one-tenth that of Viread.
iv. Vemlidy has greater plasma stability, enabling it to deliver tenofovir to hepatocytes more efficiently.
v. Renal dosing is not required for Vemlidy but is required for all other Hepatitis-B treatments.
1. Here’s why: Systemic exposure to Tenofovir disoproxil fumarate (TDF) can cause nephrotoxicity and a decrease in bone mineral density. Unlike TDF, which is converted extensively in plasma to tenofovir, TAF activation occurs intra-cellularly.
a. TAF 10 mg once daily produced circulating tenofovir levels that were 91% lower, BUT the intracellular levels were 4 times higher than a dose of the TDF 300 mg.