Journal of digestive diseases 2016 4 16() doi 10.1111/1751-2980.12349
BACKGROUND AND AIM
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.