EC grants marketing authorisation for two doses of Gilead’s Descovy

The European Commission has granted marketing authorisation for two doses of Gilead’s Descovy (emtricitabine and tenofovir alafenamide 200/10 mg and 200/25 mg; F/TAF), a fixed-dose combination for the treatment of HIV-1 infection. 

Descovy is indicated in the European Union for the treatment of adults and adolescents (ages 12 years and older with body weight at least 35 kg) in combination with other HIV antiretroviral agents. The marketing authorisation for Descovy is supported by 48-week data from a Phase III study (Study 1089) evaluating the safety and efficacy of switching virologically suppressed HIV-1 infected adult patients from regimens containing emtricitabine and tenofovir disoproxil fumarate (F/TDF; Truvada) plus a third agent to regimens containing F/TAF plus the same third agent. At Week 48, the F/TAF-based regimens were found to be statistically non-inferior to the F/TDF-based regimens, based on percentages of patients with HIV-1 RNA levels less than 50 copies per mL. The study also demonstrated statistically significant improvements in renal and bone laboratory parameters among patients receiving the F/TAF-based regimens.

The marketing authorisation is also supported by 48-week data from two pivotal Phase III studies (Studies 104 and 111) evaluating an F/TAF-based regimen (administered as Genvoya; elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/tenofovir alafenamide 10 mg; E/C/F/TAF) against an F/TDF-based regimen (administered as Stribild; elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg; E/C/F/TDF) among treatment naïve adult patients.  In these studies, certain renal and bone laboratory parameters favoured the F/TAF-based regimen over the F/TDF-based regimen. Additionally, the marketing authorisation is supported by data from studies evaluating an F/TAF-based regimen (administered as Genvoya) among adults with mild-to-moderate renal impairment and among treatment naïve adolescents. Lastly, bioequivalence studies demonstrated that the formulation of the fixed-dose combinations of Descovy achieved the same drug levels of TAF and emtricitabine in the blood as in Genvoya.

First new HIV backbone approved in the EU for over a decade

Commenting on the approval, Dr José Arribas, Associate Professor of Medicine, Autonoma University School of Medicine, Madrid, said: “Treatment backbones, paired with a third agent, are a cornerstone for successful management of HIV. Descovy is the first new HIV backbone approved in Europe in more than a decade and represents an important advance in addressing the needs of patients. The components of Descovy, either as part of a single or multi tablet regimen, offer physicians and their patients a simple and effective combination with improvements in renal and bone lab safety parameters.”

TAF is a novel targeted prodrug of tenofovir that has demonstrates high antiviral efficacy similar to and at a dose less than one-tenth that of Gilead’s Viread (tenofovir disoproxil fumarate; TDF). TAF has also demonstrated improvement in surrogate laboratory markers of renal and bone safety as compared to TDF in clinical trials in combination with other antiretroviral agents. Data show that because TAF enters cells, including HIV-infected cells, more efficiently than TDF, it can be given at a much lower dose and there is 90 percent less tenofovir in the bloodstream.