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Entecavir plus tenofovir versus entecavir plus adefovir in chronic hepatitis B patients with a suboptimal response to lamivudine and adefovir combination therapy.

Park JG, Park SY - Clin Mol Hepatol (2015)

Bottom Line: The only baseline characteristic that differed significantly between the two groups was the ETV resistance profile.The probability of a virologic response was significantly increased in ETV+TDF (P<0.001, OR=54.78, 95% CI=7.15-419.54) and decreased in patients with higher baseline viral loads (P=0.001, OR=0.18, 95% CI=0.07-0.50) in multivariate analysis.Further large-scale and long-term follow-up prospective studies are needed to explain these results.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Korea.

ABSTRACT

Background/aims: We compared the efficacies of entecavir (ETV) plus tenofovir (TDF) and ETV plus adefovir (ADV) in chronic hepatitis B (CHB) patients with genotypic resistance to lamivudine (LAM) who showed a suboptimal response to LAM and ADV combination therapy.

Methods: We reviewed 63 CHB patients with genotypic resistance to LAM who showed a suboptimal response to LAM and ADV combination therapy. Among these patients, 30 were treated with ETV + ADV and 33 were treated with ETV + TDF for 12 months.

Results: The only baseline characteristic that differed significantly between the two groups was the ETV resistance profile. The rate of a virologic response [serum hepatitis B virus (HBV) DNA level of <20 IU/mL] was significant higher for ETV+TDF than for ETV+ADV over 12 months (57.6% vs. 23.3%, P=0.006, at 6 months; 84.8% vs. 26.7%, P<0.001, at 12 months). The probability of a virologic response was significantly increased in ETV+TDF (P<0.001, OR=54.78, 95% CI=7.15-419.54) and decreased in patients with higher baseline viral loads (P=0.001, OR=0.18, 95% CI=0.07-0.50) in multivariate analysis. No serious adverse event occurred during the study period.

Conclusions: In patients with CHB who showed a suboptimal response to LAM and ADV combination therapy, ETV+TDF was superior to ETV+ADV in achieving a virologic response regardless of the HBV resistance profile. Further large-scale and long-term follow-up prospective studies are needed to explain these results.

No MeSH data available.


Related in: MedlinePlus

Mean reductions in serum HBV DNA level at 12 months in the ETV+ADV and ETV+TDF groups in patients with CHB refractory to LAM and ADV combination therapy.
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Figure 2: Mean reductions in serum HBV DNA level at 12 months in the ETV+ADV and ETV+TDF groups in patients with CHB refractory to LAM and ADV combination therapy.

Mentions: The serum HBV DNA level tended to decrease more in the ETV+TDF group than in the ETV+ADV group (Table 2, Fig. 2). Both the ETV+ADV and ETV+TDF groups showed an initial rapid reduction of serum HBV DNA level during the first 3 months (2.12 log10 IU/mL vs. 2.00 log10 IU/mL, P=0.731). While the serum HBV DNA level showed further decreases at 9 months in the ETV+TDF group (2.40 log10 IU/mL vs. 3.02 log10 IU/mL, P=0.057), the serum HBV DNA level at 12 months did not differ significantly between the ETV+ADV and ETV+TDF groups (2.60 log10 IU/mL vs. 3.02 log10 IU/mL, P=0.224).


Entecavir plus tenofovir versus entecavir plus adefovir in chronic hepatitis B patients with a suboptimal response to lamivudine and adefovir combination therapy.

Park JG, Park SY - Clin Mol Hepatol (2015)

Mean reductions in serum HBV DNA level at 12 months in the ETV+ADV and ETV+TDF groups in patients with CHB refractory to LAM and ADV combination therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612285&req=5

Figure 2: Mean reductions in serum HBV DNA level at 12 months in the ETV+ADV and ETV+TDF groups in patients with CHB refractory to LAM and ADV combination therapy.
Mentions: The serum HBV DNA level tended to decrease more in the ETV+TDF group than in the ETV+ADV group (Table 2, Fig. 2). Both the ETV+ADV and ETV+TDF groups showed an initial rapid reduction of serum HBV DNA level during the first 3 months (2.12 log10 IU/mL vs. 2.00 log10 IU/mL, P=0.731). While the serum HBV DNA level showed further decreases at 9 months in the ETV+TDF group (2.40 log10 IU/mL vs. 3.02 log10 IU/mL, P=0.057), the serum HBV DNA level at 12 months did not differ significantly between the ETV+ADV and ETV+TDF groups (2.60 log10 IU/mL vs. 3.02 log10 IU/mL, P=0.224).

Bottom Line: The only baseline characteristic that differed significantly between the two groups was the ETV resistance profile.The probability of a virologic response was significantly increased in ETV+TDF (P<0.001, OR=54.78, 95% CI=7.15-419.54) and decreased in patients with higher baseline viral loads (P=0.001, OR=0.18, 95% CI=0.07-0.50) in multivariate analysis.Further large-scale and long-term follow-up prospective studies are needed to explain these results.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Korea.

ABSTRACT

Background/aims: We compared the efficacies of entecavir (ETV) plus tenofovir (TDF) and ETV plus adefovir (ADV) in chronic hepatitis B (CHB) patients with genotypic resistance to lamivudine (LAM) who showed a suboptimal response to LAM and ADV combination therapy.

Methods: We reviewed 63 CHB patients with genotypic resistance to LAM who showed a suboptimal response to LAM and ADV combination therapy. Among these patients, 30 were treated with ETV + ADV and 33 were treated with ETV + TDF for 12 months.

Results: The only baseline characteristic that differed significantly between the two groups was the ETV resistance profile. The rate of a virologic response [serum hepatitis B virus (HBV) DNA level of <20 IU/mL] was significant higher for ETV+TDF than for ETV+ADV over 12 months (57.6% vs. 23.3%, P=0.006, at 6 months; 84.8% vs. 26.7%, P<0.001, at 12 months). The probability of a virologic response was significantly increased in ETV+TDF (P<0.001, OR=54.78, 95% CI=7.15-419.54) and decreased in patients with higher baseline viral loads (P=0.001, OR=0.18, 95% CI=0.07-0.50) in multivariate analysis. No serious adverse event occurred during the study period.

Conclusions: In patients with CHB who showed a suboptimal response to LAM and ADV combination therapy, ETV+TDF was superior to ETV+ADV in achieving a virologic response regardless of the HBV resistance profile. Further large-scale and long-term follow-up prospective studies are needed to explain these results.

No MeSH data available.


Related in: MedlinePlus