Comparison of clinical efficacy and renal safety of telbivudine and entecavir in chronic hepatitis B patients receiving cytotoxic chemotherapy.

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Law ST, Lee MK, Lee AS, Tung Y, Li KK,

Law ST, Lee MK, Lee AS, Tung Y, Li KK, (click to view)

Law ST, Lee MK, Lee AS, Tung Y, Li KK,

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Journal of digestive diseases 2016 4 16() doi 10.1111/1751-2980.12349

Limited data is available on clinical outcomes of telbivudine (LdT) and entecavir (ETV) in pre-emptive antiviral chemoprophylaxis. This study aimed to evaluate the clinical efficacy and renal safety of LdT and ETV in patients with chronic hepatitis B (CHB) infection receiving cytotoxic chemotherapy.

This study 290 treatment-naïve CHB patients undergoing intense chemotherapy enrolled to receivedaily 600 mg of LdT or 0.5 mg of ETV as pre-emptive antiviral chemoprophylaxis.

The ETV group had significantly higher proportion of patients with undetectable hepatitis B viral (HBV) DNA load comparedto LdTat week 24(72.99% vs. 50.33%; P 0.000). The cumulative rates of virological breakthrough in the LdT and ETV groups were 9.15% and 3.65% at the second year, respectively (P = 0.059); this was associated with undetectable HBV DNA at week 24 (P 0.000). Compared with the ETV group, Model for End-stage Liver Disease score(year 1: 4.53 vs. 7.53) and estimated glomerular filtration rates (eGFRs) (year 1: 118.17 vs. 91.79 mL/min, P 0.000; 111.14 vs. 76.45 ml/min at year 2, P 0.000) in the LdT group were significantly improved from baseline after the first year. Moreover, significant number of patients with impaired renal function had improvedeGFRs after LdTthan ETV treatment (32.68% vs. 8.76%, P 0.000).

LdT has a lower clinical efficacy in viral suppression than ETV, but LdTis associated with greater extent of improvement in liver and renal functions of patients in pre-emptive prophylaxis for cytotoxic chemotherapy. This article is protected by copyright. All rights reserved.

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