Efficacy of entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide in treatment-naive hepatitis B patients

Chon, Hye Yeon; Ahn, Sang Hoon; Kim, Yoon Jun; Yoon, Jung‐Hwan; Lee, Jeong-Hoon; Sinn, Dong Hyun; Kim, Seung Up

doi:10.1007/s12072-021-10262-y

Cited by 16 publications

(17 citation statements)

References 28 publications

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“…Several studies have previously indicated that TAF has an efficacy profile comparable to that of TDF, with significantly less bone and renal risks. 22,23 This has led to international treatment guidelines recommending switch from TDF to TAF in those who develop nephrotoxicity after the use of TDF. 10,12,13 However, no study to date has directly compared the renal safety of TAF and BSV, both of which have been previously documented to have better renal safety profiles than TDF.…”

Section: Introductionmentioning

confidence: 99%

“…10,12,13 However, no study to date has directly compared the renal safety of TAF and BSV, both of which have been previously documented to have better renal safety profiles than TDF. [21][22][23] Hence, this study aimed to compare the risk of kidney function decline among patients with treatment-naïve CHB treated with TAF or BSV.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, TAF, which is the prodrug form of tenofovir, has been developed to overcome the renal side effects of TDF. Several studies have previously indicated that TAF has an efficacy profile comparable to that of TDF, with significantly less bone and renal risks 22,23 . This has led to international treatment guidelines recommending switch from TDF to TAF in those who develop nephrotoxicity after the use of TDF 10,12,13 …”

Section: Introductionmentioning

confidence: 99%

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Similar risk of kidney function decline between tenofovir alafenamide and besifovir dipivoxil maleate in chronic hepatitis B

Jung

Kim

Lee

et al. 2022

Liver International

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Background and Aims: Although tenofovir alafenamide (TAF) and besifovir dipivoxil maleate (BSV) are potent antiviral agents in the treatment of chronic hepatitis B (CHB) infection, their renal safety profiles have not been previously compared. This study compared the risk of kidney function decline among patients with treatment-naïve CHB treated with TAF or BSV. Methods: This multicenter, retrospective, longitudinal cohort study included 556 patients with treatment-naïve CHB treated with TAF (n = 366) or BSV (n = 190) between November 2017 and August 2021. The primary outcome was chronic kidney disease (CKD) progression, defined as an increase in CKD stage by at least one stage for at least three consecutive months.Results: 1:1 Propensity score matching yielded 154 patients in each treatment group. The mean estimated glomerular filtration rate (eGFR) was 100.4 vs. 100.3 ml/min/1.73 m 2 in the TAF and BSV groups respectively. A total of 25 patients developed a progression in CKD stage ≥1, of which 13 and 12 patients were from the TAF and BSV treated groups respectively (3.1 vs. 3.3 per 1000 person-years; p = .751). The unadjusted hazard ratio for risk of progression in CKD stage ≥1 of the BSV group (vs. the TAF group) was 1.13 (95% confidence interval, 0.50-2.58; p = .758). This association persisted even after adjusting for potential confounders. Virological, serological and biochemical responses were also similar between the two treatment groups (all p > .05).Conclusions: TAF and BSV showed a similar risk of kidney function decline in patients with treatment-naïve CHB. Further prospective randomized studies are warranted for validation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Similar risk of kidney function decline between tenofovir alafenamide and besifovir dipivoxil maleate in chronic hepatitis B

Jung

Kim

Lee

et al. 2022

Liver International

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“…Recent data regarding the HBV genotype C2 in Korea, revealed that risk of HCC steadily persisted despite long-term antiviral treatment ( Kim et al, 2020 ). It is still controversial that Tenofovir is superior to Entecavir in reducing the incidence of HCC ( Kim et al, 2019 ; Ha et al, 2020 ; Chon et al, 2021 ; Lee et al, 2020 ). Moreover, HCC inhibition by different NAs remains largely unknown in patients with DC.…”

Section: Discussionmentioning

confidence: 99%

A new model predicts hepatocellular carcinoma in patients with HBV-related decompensated liver cirrhosis and long-term antiviral therapy: a prospective study

Mao

Zheng

Yang

et al. 2023

PeerJ

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Background We aimed to evaluate the prediction values of non-invasive models for hepatocellular carcinoma (HCC) development in patients with HBV-related liver cirrhosis (LC) and long-term NA treatment. Methods Patients with compensated or decompensated cirrhosis (DC), who achieved long-term virological response, were enrolled. DC and its stages were defined by the complications including ascites, encephalopathy, variceal bleeding, or renal failure. Prediction accuracy of several risk scores, including ALBI, CAMD, PAGE-B, mPAGE-B and aMAP, was compared. Results The median follow-up duration was 37 (28–66) months. Among the 229 patients, 9 (9.57%) patients in the compensated LC group and 39 (28.89%) patients in the DC group developed HCC. The incidence of HCC was higher in the DC group ($\cal X$2 = 12.478, P < 0.01). The AUROC of ALBI, aMAP, CAMD, PAGE-B and mPAGE-B scores were 0.512, 0.667, 0.638, 0.663, 0.679, respectively. There was no significant difference in AUROC between CAMD, aMAP, PAGE-B and mPAGE-B (all P > 0.05). Univariable analysis showed that age, DC status and platelet were associated with HCC development, and multivariable analysis showed that age and DC status (both P < 0.01) were independent risk factors for HCC development, then Model (Age_DC) was developed and its AUROC was 0.718. Another model, Model (Age_DC_PLT_TBil) consisting of age, DC stage, PLT, TBil was also developed, and its AUROC was larger than that of Model (Age_DC) (0.760 vs. 0.718). Moreover, AUROC of Model (Age_DC_PLT_TBil) was larger than the other five models (all P < 0.05). With an optimal cut-off value of 0.236, Model (Age_DC_PLT_TBil) achieved 70.83% sensitivity, 76.24% specificity. Conclusion There is a lack of non-invasive risk scores for HCC development in HBV-related DC, and a new model consisting of age, DC stage, PLT, TBil may be an alternative.

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“…23 There have also been conflicting reports on the effectiveness of ETV and TDF in HCC prevention with some finding TDF to be superior while some found no significant differences between the two. [24][25][26] However, it appears that the source of heterogeneity and inconsistencies lies in the differences of not only the baseline characteristics but also the length of follow-up observation between the ETV vs TDF study populations among these various studies. Though TDF was approved only 3 years after ETV, reimbursement for TDF came many years after ETV, the higher HCC occurrence rates observed among ETV-treated patients may have been due to the fact that they were just observed for a longer time.…”

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confidence: 99%

Perspectives on the Underlying Etiology of HCC and Its Effects on Treatment Outcomes

Ito¹,

Nguyen²

2023

JHC

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Hepatocellular carcinoma (HCC) continues to be a serious medical problem with poor prognosis worldwide. The distribution of the major etiologies of HCC is changing due to the progress of anti-viral treatments, including hepatitis B virus (HBV) suppression by nucleoside/nucleotide analogues (NAs) and increased sustained virologic response (SVR) rates by direct-acting antivirals (DAAs) for hepatitis C virus (HCV), as well as the rising trend of nonviral liver disease. Although viral hepatitis remains the most common cause of HCC, non-alcoholic liver disease (NAFLD) with metabolic syndrome and alcohol-associated liver disease (ALD) are increasing. Effective and well-tolerated NAs treatment can slow the disease progression of chronic HBV infection to cirrhosis, end-stage liver disease, and reduce HCC risk. Treatment with NAs is also associated with significant improvement in the long-term survival of patients with HBV infection who already have HCC. DAAs have achieved viral elimination in almost all patients with HCV without significant adverse events, even in patients with decompensated liver cirrhosis and HCC. Similarly, DAA therapy can reduce disease progression, liver and non-liver complications, and improve the long-term survival of patients with chronic HCV infection with or without HCC. Meanwhile, NAFLD is a rapidly increasing cause of HCC along with the epidemics of obesity and type 2 diabetes globally. NAFLD-related HCC can occur in patients without cirrhosis and is known to have a lower survival rate than viral hepatitis-related HCC. Since there is currently no specific pharmacotherapy effective for NAFLD, lifestyle modification and prevention of complications are important to improve prognosis. Additionally, ALD is the second fastest-growing cause of HCCrelated deaths, especially with an accelerated trend since the COVID-19 pandemic. This review provides an overview of the epidemiologic trends in the etiologies of HCC, and the progress of treatments for each etiology and the impact on outcome in the patients with HCC.

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Efficacy of entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide in treatment-naive hepatitis B patients

Cited by 16 publications

References 28 publications

Similar risk of kidney function decline between tenofovir alafenamide and besifovir dipivoxil maleate in chronic hepatitis B

Similar risk of kidney function decline between tenofovir alafenamide and besifovir dipivoxil maleate in chronic hepatitis B

A new model predicts hepatocellular carcinoma in patients with HBV-related decompensated liver cirrhosis and long-term antiviral therapy: a prospective study

Perspectives on the Underlying Etiology of HCC and Its Effects on Treatment Outcomes

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