Mastering Straight Line Graphs: Gradient Calculation Practice
In this learning material, you will engage in calculating gradients of straight lines passing through given points. The practice questions and worked examples will enhance your understanding of determining gradients in graphing. The content includes interactive exercises to refine your skills in solving gradient calculations for various points on a graph. Dive into this resource to sharpen your knowledge of straight line graphs and boost your confidence in tackling related problems.
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Switch ABC/3TC to TAF/FTC GS-US-1717 Study
GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Design Randomisation 1 : 1 Double-blind W48 W96 TAF/FTC * + continuation 3rdagent + ABC/3TC placebo N = 280 HIV+ adults On ABC/3TC + 3rdagent 6 months HIV-1 RNA < 50 c/mL 6 months Any CD4 Creatinine clearance 50 mL/min ABC/3TC + continuation 3rdagent + TAF/FTC placebo N = 276 * TAF/FTC : 100/200 mg when coadministered with ATV boosted, DRV boosted or LPV/r ; 25/200 mg when co-administered with NNRTI, RAL, DTG or MVC Objective Primary endpoint: non-inferiority of TAF/FTC at W48: % HIV-1 RNA < 50 c/mL by ITT, snapshot analysis ; lower limit of the 95% CI for the difference = - 10%, 90% power GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Baseline characteristics and patient disposition TAF/FTC N = 280 ABC/3TC N = 276 52 52 Median age, years 14 22 Female, % 73 / 23 72 / 24 Race : white / black, % 654 700 CD4/mm3, median 8 8 Median duration on ABC/3TC, years Third agent, % NNRTI Boosted PI INI 51 30 19 53 30 16 31 (11) 1 12 10 / 3 3 1 / 0 1 18 (7) 1 9 6 / 0 0 0 / 2 0 Discontinuation by W48, N (%) For lack of efficacy, N For adverse event, N Withdrew consent / Lost to follow-up, N Investigator decision, N Non compliance / Protocol violation, N Death, N GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
88 GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Efficacy at W48 (ITT, snapshot) Per protocol analysis TAF/FTC (N = 253) ABC/3TC (N = 248) HIV RNA < 50 c/mL at W48 TAF/FTC : 99.1% ABC/3TC : 99.1% Difference : 0.0% (95% CI: -2.5 to 2.3) % 93 100 90 80 60 Difference (95% CI) : 0.8% (- 1.5 to 3.3) 40 20 9 6 2 1 0 HIV RNA < 50 c/mL HIV RNA > 50 c/mL No virologic data Emergence of resistance, N Difference : - 3.0% (95%CI : - 8.2 to 2.0) TAF/FTC ABC/3TC Genotype at virologic failure * 4 1 Emergence of resistance NRTI : K65K/R PI : M46I + I50L + N88S 1 0 1 1 1 0 * Confirmed HIV RNA > 50 c/mL or unconfirmed > 400 c/mL at last visit GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Adverse events TAF/FTC ABC/3TC Adverse events 5% in either arm, % Nasopharyngitis Upper respiratory tract infection Diarrhea Headache Arthralgia Cough Fatigue Back pain Urinary tract infection Adverse events leading to drug discontinuation, N (%) Grade 3-4 laboratory abnormalities 2% in either arm, % LDL-cholesterol Hyperbilirubinemia Creakine kinase Amylase Hypercholesterolemia 13 9 9 7 6 6 5 5 2 11 12 9 5 7 5 4 6 5 12 (4) * 22 5 5 3 3 2 9 (3) ** 18 5 3 4 2 2 * Considered related to study drug (n = 8) : abdominal distension + myalgia, nausea + vomiting + dehydration, nausea + feeling jittery + decrease appetite, anxiety, Brugada syndrome, increased creatinine, burning sensation + headache + paresthesia, vision blurred + visual field defect + eye pain ; not related to study drug : cough, tuberculosis, sudden cardiac death, neutropenia ** Considered related to study drug (n = 8) : affective disorder, panic attack, depression + bone pain + arthralgia, dermatitis + pruritus, rash + pruritus, diarrhea, myalgia + dysesthesia, tinnitus + dry mouth + dyspnea ; not related to study drug : depression + suicide attempt GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
89 GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Median changes in creatinine clearance (Q1, Q3), mL/min TAF/FTC ABC/3TC 10 No difference between groups in changes at W48: - in renal biomarkers (urine RBP:creatinine and B2M:creatinine ratios) - in bone mineral density - (hip and lumbar spine) 1.3 mL/min p = 0.05 0 - 1.1 mL/min -10 0 12 24 36 48 Weeks Median changes in fasting lipids at W48, mg/dL TAF/FTC Total LDL- HDL- Triglycerides ABC/3TC 10 cholesterol cholesterol cholesterol 4 3 2 2 0 0 0 -1 -2 p = 0.18 p = 0.54 p < 0.001 p = 0.48 -10 GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
GS-US-1717 Study: Switch ABC/3TC to TAF/FTC Conclusion Switch from ABC/3TC to TAF/FTC was non inferior to ABC/3TC in maintaining virologic suppression in combination with a variety of third agents No differences of TAF/FTC vs ABC/3TC in Renal biomarkers Bone mineral density Fasting lipids In virologically suppressed patients with creatinine clearance > 50 mL/min, TAF/FTC provides an alternative backbone to ABC/3TC with similar effects on kidney and bone GS-US-1717 Winston A, Lancet HIV.2018 ; 5:e162-71
