Thread by @peterstaley

#PrEP THREAD! After purposely delaying Descovy's development for a decade, @GileadSciences started warning doctors and people with HIV to switch from Truvada-based regimens to Descovy-based regimens, claiming it was safer. 80% switched within 3 years. /1

NOT COINCIDENTALLY, this extended Gilead's monopolies in HIV treatment & prevention since TDF, the main component of Truvada, lost patent protection in 2017. But it also switched patients from a drug used for 14yrs w/ well-documented toxicities to one that was newly approved. /2

Just like Truvada, we're learning more about Descovy after wider use in HIV+ patients. In the 2018 EMERALD Study, TAF, the main component in Descovy, caused far more grade 3/4 elevations in LDL & Total cholesterol. And unlike TDF, it caused diabetes in some patients. /3

Just this month, a study found "significant increases in weight, BMI, total cholesterol, LDL, HDL, and ASCVD risk score in the yr after switching from TDF to TAF." The 13% jump in ASCVD risk score lifted more than half the patients to scores that would require statin therapy. /4

Also this month, a Gilead-sponsored study (oops!) looking at 8 large clinical trials found that TAF was associated with a ≥10% weight gain in some patients while TDF, abacavir, and AZT were not. /5

All of these side effects were more pronounced in cisgender women. Surprise, surprise — @GileadSciences failed to study Descovy as PrEP in cisgender women. /6
nytimes.com/2019/10/04/hea…

Meanwhile, in a widely published study from 2016, the toxicity profile of Truvada as PrEP compares favorably to aspirin! /7
buzzfeednews.com/article/azeeng…

But the Gilead juggernaut won't be stopped. Docs are sending letters to their PrEP patients saying all patients are being switched to Descovy. Some AIDS service organizations are doing the same, pointing out 340B funding advantages to avoiding generics. /8
thebody.com/article/aids-a…

So I've got one question about all of this:

With this mass rush to Descovy as PrEP,

DO WE KNOW WHAT THE FUCK WE ARE DOING?

/9
@PrEP4AllNow #BreakThePatents

@PrEP4AllNow @threadreaderapp unroll