Abstract | BACKGROUND & AIMS: METHODS: We used serum creatinine-based equations (ie, Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration) to estimate GFR (eGFR) in adults with chronic hepatitis B virus infection and compensated liver disease who participated in a phase III, randomized, double-blind study comparing the efficacy and safety of telbivudine (600 mg/d) and lamivudine (100 mg/d) for 2 years (the GLOBE study) and in long-term extension studies (4-6 years), as well as in patients with decompensated cirrhosis (2 years). RESULTS: eGFRs calculated using the Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations were concordant, indicating improved renal function in telbivudine-treated patients during the 2-year GLOBE study (there was an 8.5% increase in mean eGFR, based on the Modification of Diet in Renal Disease equation). Improved renal function was maintained for 4-6 years. Increased eGFR with telbivudine treatment was also observed in patients at increased risk for renal impairment: patients with baseline eGFRs of 60-89 mL/min/1.73 m(2) (+17.2%), older than 50 years (+11.4%), and with liver fibrosis/ cirrhosis (+7.2% for patients with Ishak fibrosis score at 5-6). In decompensated patients with high renal risk, eGFR was also improved on telbivudine (+2.0%). CONCLUSIONS: In global trials of patients with compensated and decompensated cirrhosis, long-term telbivudine therapy was associated with a sustained improvement of renal function-particularly among patients with increased risk of renal impairment. The mechanisms of this renal protective effect remain to be determined.
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Authors | Edward J Gane, Gilbert Deray, Yun-Fan Liaw, Seng Gee Lim, Ching-Lung Lai, Jens Rasenack, Yuming Wang, George Papatheodoridis, Adrian Di Bisceglie, Maria Buti, Didier Samuel, Alkaz Uddin, Sophie Bosset, Aldo Trylesinski |
Journal | Gastroenterology
(Gastroenterology)
Vol. 146
Issue 1
Pg. 138-146.e5
(Jan 2014)
ISSN: 1528-0012 [Electronic] United States |
PMID | 24067879
(Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Antiviral Agents
- Telbivudine
- Creatinine
- Thymidine
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Topics |
- Adult
- Antiviral Agents
(therapeutic use)
- Creatinine
(blood)
- Double-Blind Method
- Female
- Glomerular Filtration Rate
- Hepatitis B, Chronic
(complications, drug therapy)
- Humans
- Male
- Renal Insufficiency, Chronic
(blood, complications, drug therapy)
- Telbivudine
- Thymidine
(analogs & derivatives, therapeutic use)
- Treatment Outcome
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