Academy Exchange

Expand all | Collapse all

PEP Updates

  • 1.  PEP Updates

    Posted 05-15-2020 11:46
    In an effort to improve compliance, decrease adverse effects, minimize drug interactions, and help with costs I am trying to update my institutions preferred PEP regimen. 

    the guidelines are outdated as there have been many advancements in ART since then and they really only cite evidence in HIV treatment and side effects as how to choose a preferred regimen anyway. 

    I want to use BIC/F/TAF. But most of our PEP patients are female sexual assault survivors. And the data thus far are primarily in MSM. Even that is a small number. 

    Is anyone using BIC/F/TAF at your institution? Or another STR?


    ------------------------------
    Katy Garrett, PharmD, BCIDP, AAHIVP
    HIV/HCV/HBV Clinical Pharmacist
    Portland ME
    ------------------------------


  • 2.  RE: PEP Updates

    Posted 05-15-2020 16:38
    Good question!  I've been wondering about this too.

    I work at a smaller health system in central Minnesota.  We have DTG + TDF/3TC as formulary for PEP and inpatient treatment. 

    I hope someone out there provide more info.

    -Daniel

    ------------------------------
    Daniel Jude
    North Memorial Infectious Disease
    Minneapolis MN
    ------------------------------



  • 3.  RE: PEP Updates

    Posted 05-15-2020 16:40

    So we are using Truvada and tivikay because of ease of access to patient assistance for uninsured people. In women I am just ensuring they are not pregnant and encourage not to try during therapy. Birth control. Etc. The Isentress only has a mail in PAP which obviously not going to help. 



    ------------------------------
    David Cupit
    Houston TX
    ------------------------------



  • 4.  RE: PEP Updates

    Posted 05-15-2020 20:15
    Katy,
    I was just wondering, have you had a chance to look at the National HIV Curriculum's Nonoccupational Postexposure Prophylaxis unit yet? We just reviewed and updated the content recently. If you register on the site, you can track your progress and also earn free CME.
    Julia


    ------------------------------
    Julia Freimund
    National HIV Curriculum, University of Washington Infectious Diseases Education and Assessment (IDEA) Program
    www.hiv.uw.edu
    ------------------------------



  • 5.  RE: PEP Updates

    Posted 05-16-2020 20:51
    We have been using Bictegravir/TAF/FTC for PEP for some time now.  I've been prescribing PEP since the initial AZT days. In the early days of three drug treatment for PEP only about 50% of health care workers were able to complete 28 days of PEP.  We know from HIV treatment that adherence is the major issue and often more important that subtleties of marginal differences between regimens.  Using a regimen that is easy to take and with few side effects is important.  In MA we are fortunate to have state funded programs for PrEP and PEP.

    ------------------------------
    Jonathan Pincus
    Codman Square Health Center
    Milton MA
    ------------------------------



  • 6.  RE: PEP Updates

    Posted 05-17-2020 16:12
    I've been using BIC/FTC/TAF for nPEP for about a year.  It easier to quickly get approval for a STR for uninsured patients or I can use samples.

    ------------------------------
    Amanda Miller
    CentroMed Santa Rosa
    San Antonio TX
    ------------------------------



  • 7.  RE: PEP Updates

    Posted 05-17-2020 18:47

    For me one of the biggest barriers is accessing PEP ( via patients insurance).  We have not yet created a great system to assure easy access to PEP meds unless the site has an onsite pharmacy ( we have very strict pharmacy "dispensing laws" so a provider providing a "starting pack" is hard). I have samples of Biktarvy, 7 days, it can be pretty easy to use

     

    Christine

     

    Christine S. Brennan PhD RN NP-BC
    Associate Professor Health Policy and System Management

    School of Public Health

    LSU Health Science Center
    cbrenn1@lsuhsc.edu
    504 905 7765

     






  • 8.  RE: PEP Updates

    Posted 05-19-2020 13:14
      |   view attached
    hot off of the press  we are getting info on a current trial of Biktarvy for PEP see attached.​ Maybe an official update to guidelines on the way?

    ------------------------------
    David Cupit
    Houston TX
    ------------------------------

    Attachment(s)

    pdf
    LRD_US_BVY_PEP.pdf   329K 1 version