Academy Exchange

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

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Daniel Jude
North Memorial Infectious Disease
Minneapolis MN
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Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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the guidelines are outdated as there have been many advancements in ART since then and they really only cite evidence in HIV treatment and side effects as how to choose a preferred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

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

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David Cupit
Houston TX
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Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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the guidelines are outdated as there have been many advancements in ART since then and they really only cite evidence in HIV treatment and side effects as how to choose a preferred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

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

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


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

Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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
------------------------------

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.

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

Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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
------------------------------

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.

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Amanda Miller
CentroMed Santa Rosa
San Antonio TX
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Original Message:
Sent: 05-16-2020 20:51
From: Jonathan Pincus
Subject: PEP Updates

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

Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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
------------------------------

Original Message------

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.

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

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?

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

Original Message:
Sent: 05-15-2020 11:45
From: Katy Garrett
Subject: PEP Updates

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
------------------------------