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ACTHIV 2016 Conference - Switching ART

ACTHIV 2016 Conference - Switching ART
ACTHIV 2016 Conference - Switching ART
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ACTHIV
Resource ID: CM415
Original Presentation: 4/28/2016
Web Posting: 9/15/2016
CE Expiration: 09/15/2017

The enduring material is jointly provided by William Beaumont Hospital, American Academy of CME, Inc., and the American Conference for the Treatment of HIV (ACTHIV).

The 10th Annual American Conference for the Treatment of HIV (ACTHIV) was held April 28-30, 2016 in Dallas, TX. The Conference was supported by funding from the Clinical Education Initiative, New York State Department of Health, AIDS Institute; and from the HIV Medicine Association (HIVMA). The conference and this web archive were supported by educational grants from Bristol-Myers Squibb; Gilead Sciences; Janssen Therapeutics, Division of Janssen Products, LP; Merck & Co.; and ViiV Healthcare.

ONLINE CE CREDIT:

To obtain online CE credit, please follow this link to the course post-test quiz and follow the instructions.

FACULTY:
Joel Gallant, MD, MPH, is the Medical Director of Specialty Services at the Southwest CARE Center in Santa Fe, New Mexico. He is Adjunct Professor of Medicine in the Division of Infectious Diseases at the Johns Hopkins University School of Medicine in Baltimore, and Clinical Professor of Medicine at the University of New Mexico School of Medicine.

Estimated time to complete: 30 minutes

TARGET AUDIENCE
Physicians (both specialists and primary care/family medicine), nurse practitioners, and nurses who are frontline providers of care to persons at risk of or with HIV infection. Physician assistants, pharmacists, case managers and other healthcare professionals may also participate.

Learning Objectives
As a result of participating in this activity, participants should be better able to:

  • List the reasons to consider switching therapy in virologically suppressed patient according to latest DHHS guidelines
  • Review the results of recent "switch" trials
  • Identify the risks of switching therapy in a treatment-experienced patient and how to maximize the safety of switching

ACCREDITATION

Physicians:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of William Beaumont Hospital, American Academy of CME, Inc., and the American Conference for the Treatment of HIV (ACTHIV). William Beaumont Hospital is accredited by the ACCME to provide continuing medical education for physicians.

William Beaumont Hospital designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses and Nurse Practitioners:

American Academy of CME, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

American Academy of CME, Inc. designates this educational activity for 0.5 contact hours (0.5 pharmacotherapeutic contact hours).

Physician Assistants:

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 0.5 hours of Category I credit for completing this program.

There is no fee to participate in this activity.

HOW TO RECEIVE CREDIT

In order to obtain your certificate of credit, you must:

  • read the CME/CE information and review the full content of the activity
  • achieve a passing grade on the post-test (75% or greater), and
  • complete the evaluation.

Your certificate for the activity will be made available immediately to print online.

DISCLOSURES

According to the disclosure policy of Academy and Beaumont, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence. Disclosures will be made known to the participants prior to the activity.

The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy, Beaumont, ACTHIV or the American Nurses Credentialing Council’s Commission on Accreditation. This educational activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.

Off-Label Usage Disclosure

This activity does not contain off-label discussion.

Faculty Disclosure

Joel Gallant, MD, MPH, indicated he has the following relevant financial relationships to disclose: Advisory Boards: Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., ViiV Healthcare; Grant Recipient / Research Support: AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., Sangamo BioSciences, ViiV Healthcare

Planner Disclosures

The following planners have indicated they have no relevant financial relationships to disclose: Bruce Agins, MD; John T. Brooks, MD; Courtney Fletcher, PharmD; Monica Gandhi, MD, MPH; John JD Juchniewicz, MCIS, CHCP; Natalie Kirkwood, RN, BSN, JD; Edward Moylan, RP; Tonia Poteat, PhD, MPH, PA-C; Asa E. Radix, MD, MPH; Cheryl Smith, MD; Brooke J.Taylor, MPH, CHCP; Barbara A. Young, MSW, LCSE, LCADC, SAC.

The following planners have indicated they have relevant financial relationships to disclose:

Laura Armas-Kolostroubis, MD - Advisory Board: Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Theratech; Grant Recipient/Research Support: AbbVie, Bristol-Myers Squibb, Gilead Sciences, Merck & Co., ViiV Healthcare; Promotional Speakers Bureau: Gilead Sciences
Roger Bedimo, MD, MS - Advisory Board: Bristol-Myers Squibb, Merck & Co., Theratechnologies; Grant Recipient/Research Support: Bristol-Myers Squibb, Merck & Co.
Elizabeth Connick, MD - Data Safety Monitoring Board: City of Hope, Sangamo Biosciences
Carlos del Rio, MD - Consultant: InnaVirVax; Board Member: HIVMA, IAS-USA
Donna Futterman, MD - Grant Recipient / Research Support: Gilead Sciences
Joel Gallant, MD, MPH - Advisory Boards: Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., ViiV Healthcare; Grant Recipient / Research Support: AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., Sangamo BioSciences, ViiV Healthcare
Rajesh Gandhi, MD - Grant Recipient / Research Support: EBSCO, Gilead Sciences, Merck & Co., Roche, ViiV Healthcare
Sharon Hillier, PhD - Advisory Board: Merck & Co., Perrigo, Symbiomix; Consultant: Merck & Co., Symbiomix; Grant/Research Support: Symbiomix
Peter Hunt, MD - Advisory Board: Merck & Co.; Consultant: Gilead Sciences, Merck & Co., ViiV Healthcare; Honoraria (non-promotional lectures on immune activation): Gilead Sciences, Janssen Therapeutics
Harry Lampiris, MD - Consultant: GLG Consultants
Sharon Lee, MD - Advisory Board: Gilead Sciences, ViiV Healthcare
Vincent Lo Re, MD, MSCE - Advisory Board: Gilead Sciences, ViiV Healthcare; Grant / Research Support: AstraZeneca
Michael J. Mugavero, MD, MHSc - Advisory Board / Consultant: Bristol-Myers Squibb, Gilead Services, Merck Foundation; Board of Directors: HarborPath; Grant / Research Support: Bristol-Myers Squibb
Renslow Sherer, MD - Advisory Board: Gilead Sciences; Grant Recipient/Research Support: Gilead Sciences, Janssen Therapeutics
William R. Short, MD, MPH - Advisory Board: Gilead Sciences, Janssen Therapeutics; Consultant: Gilead Sciences; Promotional Speakers Bureaus: Gilead Sciences, Janssen Therapeutics
Kathleen E. Squires, MD - Advisory Board: Gilead Sciences, Janssen Therapeutics, Bristol-Myers Squibb, Merck & Co., ViiV Healthcare; Consultant: Merck & Co.; Grant Recipient / Research Support: Gilead Sciences
Melanie Thompson, MD - Grant Recipient/Research Support: Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Merck Research Laboratories, Pfizer Roche Diagnostics, TaiMed, Inc., ViiV Healthcare
Andrea Weddle, MSW - Advisory Board (ACA): Janssen Therapeutics

Privacy Policy
For more information about Beaumont’s privacy policy, please access http://www.beaumont.edu/privacy-policy
For more information about Academy privacy policy, please access http://www.academycme.org/privacy.htm

For CME information or credit details, contact: cme@beaumont.edu

For CNE information or credit details, contact: CEservices@academycme.org

Hardware/Software Requirements To access this activity hardware and software requirements are noted below.

Windows Requirements: • Operating system: Windows XP Service Pack 2 or later • Browser: Internet Explorer 7 or later, Mozilla Firefox 2.5 or later • Internet connection: DSL, cable modem, or other high-speed connection • Flash: Adobe Flash Player 9 or later
Macintosh Requirements: • Operating system: Mac OS X v10.3 or later • Browser: Mozilla Firefox 2.5 or later • Internet connection: DSL, cable modem, or other high-speed connection • Flash: Adobe Flash Player 9 or later

Copyright 2015. American Academy of CME, Inc., William Beaumont Hospital, and American Conference for the Treatment of HIV.

Bibliographic Sources:

  • Lee W et. Selective intracellular activation of a novel prodrug of the human immunodeficiency virus reverse transcriptase inhibitor tenofovir leads to preferential distribution and accumulation in lymphatic tissue. Antimicr Agents Chemo 2005;49(5):1898-1906.
  • Birkus G et al. Cathepsin A is the major hydrolase catalyzing the intracellular hydrolysis of the antiretroviral nucleotide phosphonoamidate prodrugs GS-7340 and GS-9131. Antimicr Agents Chemo 2007;51(2):543-550.
  • Babusis D, et al. Mechanism for effective lymphoid cell and tissue loading following oral administration of nucleotide prodrug GS-7340. Mol Pharm 2013;10(2):459-66.
  • Ruane P, et al. Antiviral activity, safety, and pharmacokinetics/pharmacodynamics of tenofovir alafenamide as 10-day monotherapy in HIV-1-positive adults. J Acquir Immune Defic Syndr 2013; 63:449-5.
  • Sax P, et al. Tenofovir alafenamide vs. tenofovir disoproxil fumarate in single tablet regimens for initial HIV- 1 therapy: a randomized phase 2 study. JAIDS 2014. 2014 Sep 1;67(1):52-8.
  • Mills A, et al. Switching from tenofovir disoproxil fumarate to tenofovir alafenamide in antiretroviral regimens for virologically suppressed adults with HIV-1 infection: a randomised, active-controlled, multicentre, open-label, phase 3, non-inferiority study. Lancet Infect Dis 2016;16:43-52
  • Pozniack et al. Switching to Tenofovir Alafenamide, Coformulated With Elvitegravir, Cobicistat, and Emtricitabine, in HIV-Infected Patients With Renal Impairment: 48-Week Results From a Single-Arm, Multicenter, Open-Label Phase 3 Study. J Acquir Immune Defic Syndr. 2016;15;71:530-7
  • Gallant J, et al. Efficacy and safety of tenofovir alafenamide versus tenofovir disoproxil fumarate given as fixed-dose combinations containing emtricitabine as backbones for treatment of HIV-1 infection in virologically suppressed adults: a randomised, double-blind, active-controlled phase 3 trial. Lancet HIV 2016;3:e158-65.
  • Eron JJ, et al. Switch to a raltegravir-based regimen versus continuation of a lopinavir-ritonavir-based regimen in stable HIV-infected patients with suppressed viraemia (SWITCHMRK 1 and 2): two multicentre, double-blind, randomised controlled trials. Lancet. 2010;375:396-407.
  • See also posters and abstracts from meetings cited in presentation.

Presenter
  • Joel Gallant, MD, MpH
    Southwest Care Center
Presenter Bio
Joel Gallant, MD, MpH
Joel Gallant, MD, MPH, is the Medical Director of Specialty Services at the Southwest CARE Center in Santa Fe, New Mexico. He is Adjunct Professor of Medicine in the Division of Infectious Diseases at the Johns Hopkins University School of Medicine in Baltimore, where he was previously the Associate Director of the Johns Hopkins AIDS Service. He is a Clinical Professor of Medicine at the University of New Mexico School of Medicine. He conducts clinical trials on the treatment of HIV infection and viral hepatitis and has been an investigator in the HIV Prevention Trials Network (HPTN), the Multicenter AIDS Cohort (MACS), and the AIDS Clinical Trials Group (ACTG). Within the HPTN and ACTG he has been involved in international clinical trials, especially in Chiang Mai, Thailand.