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- Title
A comparison of telbivudine and entecavir for chronic hepatitis B in real-world clinical practice.
- Authors
Tsai, Ming-Chao; Lee, Chuan-Mo; Chiu, King-Wah; Hung, Chao-Hung; Tung, Wei-Chih; Chen, Chien-Hung; Tseng, Po-Lin; Chang, Kuo-Chin; Wang, Jing-Houng; Lu, Sheng-Nan; Yen, Yi-Hao; Hu, Tsung-Hui
- Abstract
Objectives To evaluate the efficacy of telbivudine and entecavir in chronic hepatitis B (CHB) patients over a 1 year period. Methods Ninety-seven telbivudine-naive and 98 entecavir-naive CHB patients who had been treated for at least 1 year were enrolled. Serial serum hepatitis B virus (HBV) DNA levels were checked at baseline and at weeks 24 and 48 after treatment. Results Entecavir and telbivudine groups had similar baseline HBV DNA levels (5.9 ± 1.7 versus 6.0 ± 1.5 log copies/mL, P = 0.529). The undetectable rate of HBV DNA after 1 year of treatment was significantly higher in the entecavir group than the telbivudine group (94.9% versus 82.0%, P = 0.009). Resistance developed in 6.7% of the telbivudine-naive patients after 1 year compared with none of the entecavir-naive patients (P = 0.009). However, there was a significant difference between the telbivudine and entecavir groups in hepatitis B e antigen (HBeAg) seroconversion 24 weeks after treatment (40% versus 12.5%, P = 0.007). Multiple logistic regression analysis revealed that baseline alanine aminotransferase (ALT) >200 IU/L (P = 0.008) was independently associated with HBeAg seroconversion. Applying the roadmap concept with ALT >2× upper limit of normal at baseline, telbivudine and entecavir had favourable outcomes in PCR negativity, ALT normalization, HBeAg seroconversion and resistance. Conclusions In real-world clinical practice, telbivudine resulted in higher rates of HBeAg seroconversion and drug resistance at week 48 compared with entecavir. A combination with baseline ALT plus 24 week HBV DNA levels led to the lowest rates of resistance in HBeAg-positive telbivudine-naive patients and had the highest probability of HBeAg seroconversion in both entecavir- and telbivudine-naive patients.
- Subjects
HEPATITIS B; HEPATITIS B virus; DRUG resistance; ANTIGENS; DRUG side effects
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2012, Vol 67, Issue 3, p696
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkr495