Lamivudine plus Adefovir or Telbivudine plus Adefovir for Chronic Hepatitis B Patients with Suboptimal Response to Adefovir

Chen, En‐Qiang; Zhou, Tong; Bai, Lang; Wang, Jingrong; Yan, Li; Liang, Ling-Bo; Tang, Hong

doi:10.3851/imp2190

Cited by 11 publications

(14 citation statements)

References 37 publications

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“…Another possible explanation is that the emergence of ADVresistant HBV strains following suboptimal response to LAM + ADV might attenuate the superior viral suppressive effect of LdT to that of LAM in these study patients. This is supported by a recent study which reported no differences in virologic and biochemical responses in the comparison of two treatments, LdT + ADV and LAM + ADV, in CHB patients with suboptimal response to ADV monotherapy [44] .…”

Section: Discussionsupporting

confidence: 55%

Efficacy of switching to telbivudine plus adefovir in suboptimal responders to lamivudine plus adefovir

Park

Kim

et al. 2013

WJG

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Section: Discussionsupporting

confidence: 55%

Efficacy of switching to telbivudine plus adefovir in suboptimal responders to lamivudine plus adefovir

Park

Kim

et al. 2013

WJG

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“…Though LAM + ADV has been widely used for rescue therapy in past years for those patients [5,13], patients with sequential LAM and ADV resistance had resistant mutations on the same HBV genome, which anticipated that the combination therapy of LAM + ADV might be unsatisfactory for the CHB patients with genotypic resistance associated with sequential LAM and ADV treatment. Indeed, recent data also showed that the combination therapy of LAM + ADV was not effective and was inferior to ETV containing treatment in suppressing HBV DNA [14], which indicated that ETV based combination therapy would be more superior to the LAM + ADV combination therapy in management of LAM- or ADV- resistant patients. And this superiority of ETV + ADV could be explained by the effect of ETV against ADV resistant mutation and the effect of ADV against LAM resistant mutation.…”

Section: Discussionmentioning

confidence: 99%

Entecavir plus adefovir rescue therapy for chronic hepatitis B patients after multiple treatment failures in real-life practice

Yang

et al. 2013

Virol J

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AimTo evaluate the efficacy and safety of Entecavir (ETV) plus adefovir (ADV) for chronic hepatitis B (CHB) patients after multiple nucleos(t)ide analogue (NAs) failure treatment.MethodsHepatitis B e antigen (HBeAg)-positive patients who had a suboptimal response or developed resistance to two or more previous NAs treatments were included, and all subjects were treated with ETV in combination with ADV for ≥ 24 months. Complete virologic response (CVR) was defined as an undetectability of serum hepatitis B virus (HBV) DNA level during treatment. Safety assessment was based on the increasing of serum creatinine and creatine kinase levels.ResultsA total of 45 eligible patients were included. Twenty-five patients had been treated with lamivudine (LAM) or telbivudine (LdT) and developed genotypic resistance. Resistance to ADV was present in 18 patients and 4 patients had a suboptimal response to ETV. Two patients had a resistance to both LAM and ADV. The cumulative probabilities of CVR at 12 and 24 months of ETV + ADV treatment were 88.9% (40/45) and 97.8% (44/45), respectively. Although one patient failed to achieve CVR, its serum HBV DNA level decreased by 3.3 log copies/mL after 24 months of combination therapy. The cumulative probability of HBeAg seroconversion was 15.6% (7/45) and 26.7% (12/45) at 12 and 24 months of treatment, respectively. History of prior exposure to specific NAs did not make a difference to ETV + ADV treatment outcome. There were no significant adverse events related to ETV + ADV therapy observed in the study subjects.ConclusionETV + ADV can be used as an effective and safe rescue therapy in patients after multiple NA therapy failures, especially in the areas where tenofovir is not yet available.

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“…Chen et al . also evaluated two different combination therapies in patients with suboptimal response to ADV. Both LAM plus ADV and LdT plus ADV led to notable decrease in viral load, and the rates of BR (76% vs 90%) and VR (81.1% vs 88.6%) were similar between the two groups 12 months after combination treatments.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of telbivudine treatment for hepatitis B e antigen‐positive chronic hepatitis B patients with poor response to adefovir dipivoxil

Zhang

Wang

et al. 2013

Journal of Viral Hepatitis

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Telbivudine (LdT) has demonstrated potent antiviral activity in nucleos(t)ide analogue (NA)-naïve chronic hepatitis B patients (CHB), but data on its efficacy in NA-experienced patients are limited. The aim of this study was to investigate the effect of LdT in hepatitis B e antigen-positive CHB patients with poor response to initial adefovir dipivoxil (ADV). Forty-two CHB patients with HBV DNA > 4 log10 copies/mL after 12 months of ADV monotherapy were enroled in the study and thereafter treated with LdT 600 mg daily for 18 months. Telbivudine led to a rapid decrease in viral load, and viral replication was persistently suppressed with a reduction of 2.26 log10 copies/mL 18 months after LdT treatment. The rates corresponding to virological and biochemical response at the end of observation were 97.6% (41/42) and 65.8% (25/38), respectively. HBeAg loss was found in 30.8% (12/39) of patients, while HBeAg/anti-HBe seroconversion was found in 17.9% (7/39). Only one patient was detected to have LdT-associated mutation, and no severe adverse events were reported. Optimization therapy with LdT monotherapy may be a good choice for CHB patients with poor response to ADV, and switching to LdT may be the most cost-effective rescue therapeutic strategy for patients with poor response to initial ADV monotherapy.

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Lamivudine plus Adefovir or Telbivudine plus Adefovir for Chronic Hepatitis B Patients with Suboptimal Response to Adefovir

Abstract: Both combination therapies led to a significant decrease in HBV DNA. HBeAg serological outcomes were higher with telbivudine plus ADV combination therapy.

Cited by 11 publications

References 37 publications

Efficacy of switching to telbivudine plus adefovir in suboptimal responders to lamivudine plus adefovir

Efficacy of switching to telbivudine plus adefovir in suboptimal responders to lamivudine plus adefovir

Entecavir plus adefovir rescue therapy for chronic hepatitis B patients after multiple treatment failures in real-life practice

Efficacy of telbivudine treatment for hepatitis B e antigen‐positive chronic hepatitis B patients with poor response to adefovir dipivoxil

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