Efficacy and Safety of Tenofovir Disoproxil Fumarate in Treatment-Naïve Patients with Chronic Hepatitis B in Korea.

Abstract

AIMS:

To evaluate the efficacy and safety of 144-week tenofovir disoproxil fumarate (TDF) therapy in treatment-naïve chronic hepatitis B (CHB) patients in Korean.

METHODS:

In total, 579 treatment-naïve CHB patients at 11 medical centers were enrolled retrospective and prospective from September 2015 to January 2016 by design (NCT02533544). We evaluated the complete virologic response (CVR) rate and the renal safety of TDF.

RESULTS:

The overall CVR rate was 69.4%, 87.0%, and 89.7% at weeks 48, 96, and 144, respectively. In the HBeAg-positive CHB patients, the CVR rate at weeks 48, 96, and 144 was 61.4%, 83.1%, and 89.6%, respectively. The rates of HBeAg loss and seroconversion at weeks 48, 96, and 144 were 16.6%, 23.5%, 34.1%, and 7.6%, 8.9%, 13.3%, respectively. In HBeAg-negative CHB patients, the CVR rate at weeks 48, 96, and 144 was 82.5%, 93.2%, and 90.0%, respectively. The rate of alanine aminotransferase normalization was 36.9%, 45.4%, and 46.8% at weeks 48, 96, and 144, respectively. Of the CHB patients, 0.9% showed an elevated creatinine (> 0.5 mg/dL from baseline). Age (≥ 60 years) was significantly associated with a decline in renal function at week 144 (P < 0.0001). Comorbidities (diabetes or hypertension) showed the tendency to reduce renal function (P = 0.0624). Hepatocellular carcinoma developed in 10 (1.7%) patients and was related to cirrhosis.

CONCLUSIONS:

TDF therapy induced sustained viral suppression and had a favorable safety profile over a 3-year period. However, close monitoring of renal function should be mandatory in treating CHB patients receiving TDF, particularly older patients.

• Authors: Jung Hyun Kwon, Myeong Jun Song, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, U Im Chang, Jin Mo Yang, Chan Ran You, Sang Wook Choi, Hae Lim Lee, Sung Won Lee, Nam Ik Han, Soon Woo Nam, Sang Gyune Kim, Young Seok Kim, Seok Hyun Kim, Byung Seok Lee, Tae Hee Lee, Eun-Young Cho
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 64 Issue 7 Pg. 2039-2048 (07 2019) ISSN: 1573-2568 [Electronic] United States
• PMID: 30725293 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Tenofovir

Topics

• Adult
• Antiviral Agents (adverse effects, therapeutic use)
• Female
• Hepatitis B, Chronic (diagnosis, drug therapy)
• Humans
• Kidney (drug effects, physiopathology)
• Kidney Diseases (chemically induced, physiopathology)
• Male
• Middle Aged
• Patient Safety
• Prospective Studies
• Republic of Korea
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sustained Virologic Response
• Tenofovir (adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome
• Viral Load