Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir
Background and Aim In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of teno...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2015-10, Vol.30 (10), p.1514-1521 |
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| creator | Kim, Byung Gyu Jung, Seok Won Kim, Eun Hye Kim, Jae Hee Park, Ju Hwan Sung, Shi Jung Park, Bo Ryung Kim, Min-Ho Kim, Chang Jae Lee, Byung Uk Park, Jae Ho Jeong, In Du Bang, Sung-Jo Shin, Jung Woo Park, Neung Hwa |
| description | Background and Aim
In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of tenofovir (TDF) rescue regimens in patients with multidrug resistance (MDR).
Methods
We investigated the antiviral efficacy of TDF/LAM combination therapy versus TDF/ETV combination therapy in 52 patients who failed three previous antiviral therapies.
Results
The study subjects were treated with TDF/LAM combination therapy (n = 25) or TDF/ETV combination therapy (n = 27) for more than six months. Virologic response (VR) occurred in 39 (75%) patients (19 patients belonged to the TDF/LAM group and 20 patients belonged to the TDF/ETV group). The VR rates were not different between the TDF/LAM and TDF/ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF/LAM combination or TDF/ETV combination was not statistically different according to types of MDR. In multivariate analysis, absolute HBV‐DNA level at the start of TDF rescue treatment (P |
| doi_str_mv | 10.1111/jgh.12993 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1711539804</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1711539804</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3633-a29813d5675a05cd918fc87efe761bd08dccf516bdbcd1363e79f4ca4cd59c23</originalsourceid><addsrcrecordid>eNp1kE9vFCEYh4nR2G314BcwHDVxWliGYTjqxm7bbNpoNvVIGHhxqPNnC0y3e_SbS7ttb3LhJTy_501-CH2g5Jjmc3Lzuz2mcynZKzSjZUkKKsrqNZqRmvJCMioP0GGMN4SQkgj-Fh3MuRRM0GqG_q5hGN1450PR6AgWB4hmApxaCHqzw24M2LRhHLzBLWx08slH_A0_TDCkiLftiFttsdO-y_EUQKc-_-CtTy3udO_vJusH-IK1hcdFeRoszggYnZ_v0Bunuwjvn-4jtD79vl6cFaur5fni66owrGKs0HNZU2Z5Jbgm3FhJa2dqAQ5ERRtLamuM47RqbGMszREQ0pVGl8ZyaebsCH3aazdhvJ0gJtX7aKDr9ADjFBUVlHIma1Jm9PMeNWGMMYBTm-B7HXaKEvVQuMqFq8fCM_vxSTs1PdgX8rnhDJzsgW3uZ_d_k7pYnj0ri33CxwT3Lwkd_qgqO7n6dblUi9Mf16vq57VasX86yJxA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1711539804</pqid></control><display><type>article</type><title>Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Byung Gyu ; Jung, Seok Won ; Kim, Eun Hye ; Kim, Jae Hee ; Park, Ju Hwan ; Sung, Shi Jung ; Park, Bo Ryung ; Kim, Min-Ho ; Kim, Chang Jae ; Lee, Byung Uk ; Park, Jae Ho ; Jeong, In Du ; Bang, Sung-Jo ; Shin, Jung Woo ; Park, Neung Hwa</creator><creatorcontrib>Kim, Byung Gyu ; Jung, Seok Won ; Kim, Eun Hye ; Kim, Jae Hee ; Park, Ju Hwan ; Sung, Shi Jung ; Park, Bo Ryung ; Kim, Min-Ho ; Kim, Chang Jae ; Lee, Byung Uk ; Park, Jae Ho ; Jeong, In Du ; Bang, Sung-Jo ; Shin, Jung Woo ; Park, Neung Hwa</creatorcontrib><description>Background and Aim
In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of tenofovir (TDF) rescue regimens in patients with multidrug resistance (MDR).
Methods
We investigated the antiviral efficacy of TDF/LAM combination therapy versus TDF/ETV combination therapy in 52 patients who failed three previous antiviral therapies.
Results
The study subjects were treated with TDF/LAM combination therapy (n = 25) or TDF/ETV combination therapy (n = 27) for more than six months. Virologic response (VR) occurred in 39 (75%) patients (19 patients belonged to the TDF/LAM group and 20 patients belonged to the TDF/ETV group). The VR rates were not different between the TDF/LAM and TDF/ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF/LAM combination or TDF/ETV combination was not statistically different according to types of MDR. In multivariate analysis, absolute HBV‐DNA level at the start of TDF rescue treatment (P < 0.001; OR, 0.452; 95% CI, 0.306–0.666) was only significantly associated with VR.
Conclusions
TDF/ETV combination therapy was not associated with higher rate of VR compared with TDF/LAM combination therapy in MDR CHB patients. These results raise the suspicion about the superiority of the combination therapy over TDF monotherapy. The lower HBV‐DNA levels at the start of TDF‐based rescue therapy were associated with higher VR.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.12993</identifier><identifier>PMID: 25973716</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject><![CDATA[Adenine - analogs & derivatives ; Adult ; Antiviral Agents - administration & dosage ; chronic hepatitis B ; DNA, Viral - blood ; Drug Resistance, Multiple ; Drug Therapy, Combination ; Female ; Guanine - administration & dosage ; Guanine - analogs & derivatives ; Hepatitis B virus - genetics ; Hepatitis B, Chronic - drug therapy ; Hepatitis B, Chronic - virology ; Humans ; Lamivudine - administration & dosage ; Male ; Middle Aged ; multidrug resistance ; Multivariate Analysis ; Organophosphonates ; tenofovir ; Tenofovir - administration & dosage ; Treatment Failure]]></subject><ispartof>Journal of gastroenterology and hepatology, 2015-10, Vol.30 (10), p.1514-1521</ispartof><rights>2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd</rights><rights>2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3633-a29813d5675a05cd918fc87efe761bd08dccf516bdbcd1363e79f4ca4cd59c23</citedby><cites>FETCH-LOGICAL-c3633-a29813d5675a05cd918fc87efe761bd08dccf516bdbcd1363e79f4ca4cd59c23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.12993$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.12993$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25973716$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Byung Gyu</creatorcontrib><creatorcontrib>Jung, Seok Won</creatorcontrib><creatorcontrib>Kim, Eun Hye</creatorcontrib><creatorcontrib>Kim, Jae Hee</creatorcontrib><creatorcontrib>Park, Ju Hwan</creatorcontrib><creatorcontrib>Sung, Shi Jung</creatorcontrib><creatorcontrib>Park, Bo Ryung</creatorcontrib><creatorcontrib>Kim, Min-Ho</creatorcontrib><creatorcontrib>Kim, Chang Jae</creatorcontrib><creatorcontrib>Lee, Byung Uk</creatorcontrib><creatorcontrib>Park, Jae Ho</creatorcontrib><creatorcontrib>Jeong, In Du</creatorcontrib><creatorcontrib>Bang, Sung-Jo</creatorcontrib><creatorcontrib>Shin, Jung Woo</creatorcontrib><creatorcontrib>Park, Neung Hwa</creatorcontrib><title>Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of tenofovir (TDF) rescue regimens in patients with multidrug resistance (MDR).
Methods
We investigated the antiviral efficacy of TDF/LAM combination therapy versus TDF/ETV combination therapy in 52 patients who failed three previous antiviral therapies.
Results
The study subjects were treated with TDF/LAM combination therapy (n = 25) or TDF/ETV combination therapy (n = 27) for more than six months. Virologic response (VR) occurred in 39 (75%) patients (19 patients belonged to the TDF/LAM group and 20 patients belonged to the TDF/ETV group). The VR rates were not different between the TDF/LAM and TDF/ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF/LAM combination or TDF/ETV combination was not statistically different according to types of MDR. In multivariate analysis, absolute HBV‐DNA level at the start of TDF rescue treatment (P < 0.001; OR, 0.452; 95% CI, 0.306–0.666) was only significantly associated with VR.
Conclusions
TDF/ETV combination therapy was not associated with higher rate of VR compared with TDF/LAM combination therapy in MDR CHB patients. These results raise the suspicion about the superiority of the combination therapy over TDF monotherapy. The lower HBV‐DNA levels at the start of TDF‐based rescue therapy were associated with higher VR.</description><subject>Adenine - analogs & derivatives</subject><subject>Adult</subject><subject>Antiviral Agents - administration & dosage</subject><subject>chronic hepatitis B</subject><subject>DNA, Viral - blood</subject><subject>Drug Resistance, Multiple</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Guanine - administration & dosage</subject><subject>Guanine - analogs & derivatives</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Hepatitis B, Chronic - virology</subject><subject>Humans</subject><subject>Lamivudine - administration & dosage</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidrug resistance</subject><subject>Multivariate Analysis</subject><subject>Organophosphonates</subject><subject>tenofovir</subject><subject>Tenofovir - administration & dosage</subject><subject>Treatment Failure</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE9vFCEYh4nR2G314BcwHDVxWliGYTjqxm7bbNpoNvVIGHhxqPNnC0y3e_SbS7ttb3LhJTy_501-CH2g5Jjmc3Lzuz2mcynZKzSjZUkKKsrqNZqRmvJCMioP0GGMN4SQkgj-Fh3MuRRM0GqG_q5hGN1450PR6AgWB4hmApxaCHqzw24M2LRhHLzBLWx08slH_A0_TDCkiLftiFttsdO-y_EUQKc-_-CtTy3udO_vJusH-IK1hcdFeRoszggYnZ_v0Bunuwjvn-4jtD79vl6cFaur5fni66owrGKs0HNZU2Z5Jbgm3FhJa2dqAQ5ERRtLamuM47RqbGMszREQ0pVGl8ZyaebsCH3aazdhvJ0gJtX7aKDr9ADjFBUVlHIma1Jm9PMeNWGMMYBTm-B7HXaKEvVQuMqFq8fCM_vxSTs1PdgX8rnhDJzsgW3uZ_d_k7pYnj0ri33CxwT3Lwkd_qgqO7n6dblUi9Mf16vq57VasX86yJxA</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Kim, Byung Gyu</creator><creator>Jung, Seok Won</creator><creator>Kim, Eun Hye</creator><creator>Kim, Jae Hee</creator><creator>Park, Ju Hwan</creator><creator>Sung, Shi Jung</creator><creator>Park, Bo Ryung</creator><creator>Kim, Min-Ho</creator><creator>Kim, Chang Jae</creator><creator>Lee, Byung Uk</creator><creator>Park, Jae Ho</creator><creator>Jeong, In Du</creator><creator>Bang, Sung-Jo</creator><creator>Shin, Jung Woo</creator><creator>Park, Neung Hwa</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir</title><author>Kim, Byung Gyu ; Jung, Seok Won ; Kim, Eun Hye ; Kim, Jae Hee ; Park, Ju Hwan ; Sung, Shi Jung ; Park, Bo Ryung ; Kim, Min-Ho ; Kim, Chang Jae ; Lee, Byung Uk ; Park, Jae Ho ; Jeong, In Du ; Bang, Sung-Jo ; Shin, Jung Woo ; Park, Neung Hwa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3633-a29813d5675a05cd918fc87efe761bd08dccf516bdbcd1363e79f4ca4cd59c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenine - analogs & derivatives</topic><topic>Adult</topic><topic>Antiviral Agents - administration & dosage</topic><topic>chronic hepatitis B</topic><topic>DNA, Viral - blood</topic><topic>Drug Resistance, Multiple</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Guanine - administration & dosage</topic><topic>Guanine - analogs & derivatives</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Hepatitis B, Chronic - virology</topic><topic>Humans</topic><topic>Lamivudine - administration & dosage</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidrug resistance</topic><topic>Multivariate Analysis</topic><topic>Organophosphonates</topic><topic>tenofovir</topic><topic>Tenofovir - administration & dosage</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Byung Gyu</creatorcontrib><creatorcontrib>Jung, Seok Won</creatorcontrib><creatorcontrib>Kim, Eun Hye</creatorcontrib><creatorcontrib>Kim, Jae Hee</creatorcontrib><creatorcontrib>Park, Ju Hwan</creatorcontrib><creatorcontrib>Sung, Shi Jung</creatorcontrib><creatorcontrib>Park, Bo Ryung</creatorcontrib><creatorcontrib>Kim, Min-Ho</creatorcontrib><creatorcontrib>Kim, Chang Jae</creatorcontrib><creatorcontrib>Lee, Byung Uk</creatorcontrib><creatorcontrib>Park, Jae Ho</creatorcontrib><creatorcontrib>Jeong, In Du</creatorcontrib><creatorcontrib>Bang, Sung-Jo</creatorcontrib><creatorcontrib>Shin, Jung Woo</creatorcontrib><creatorcontrib>Park, Neung Hwa</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Byung Gyu</au><au>Jung, Seok Won</au><au>Kim, Eun Hye</au><au>Kim, Jae Hee</au><au>Park, Ju Hwan</au><au>Sung, Shi Jung</au><au>Park, Bo Ryung</au><au>Kim, Min-Ho</au><au>Kim, Chang Jae</au><au>Lee, Byung Uk</au><au>Park, Jae Ho</au><au>Jeong, In Du</au><au>Bang, Sung-Jo</au><au>Shin, Jung Woo</au><au>Park, Neung Hwa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2015-10</date><risdate>2015</risdate><volume>30</volume><issue>10</issue><spage>1514</spage><epage>1521</epage><pages>1514-1521</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
In the past decade, many chronic hepatitis B (CHB) patients have undergone sequential treatment with lamivudine (LAM), adefovir (ADV), and entecavir (ETV) to manage antiviral resistance or insufficient suppression of HBV‐DNA. Very limited data are available on the efficacy of tenofovir (TDF) rescue regimens in patients with multidrug resistance (MDR).
Methods
We investigated the antiviral efficacy of TDF/LAM combination therapy versus TDF/ETV combination therapy in 52 patients who failed three previous antiviral therapies.
Results
The study subjects were treated with TDF/LAM combination therapy (n = 25) or TDF/ETV combination therapy (n = 27) for more than six months. Virologic response (VR) occurred in 39 (75%) patients (19 patients belonged to the TDF/LAM group and 20 patients belonged to the TDF/ETV group). The VR rates were not different between the TDF/LAM and TDF/ETV groups (56.0% vs 51.9% at month 12, and 72.0% vs 78.8% at month 18; log rank P = 0.515). In addition, treatment efficacy of TDF/LAM combination or TDF/ETV combination was not statistically different according to types of MDR. In multivariate analysis, absolute HBV‐DNA level at the start of TDF rescue treatment (P < 0.001; OR, 0.452; 95% CI, 0.306–0.666) was only significantly associated with VR.
Conclusions
TDF/ETV combination therapy was not associated with higher rate of VR compared with TDF/LAM combination therapy in MDR CHB patients. These results raise the suspicion about the superiority of the combination therapy over TDF monotherapy. The lower HBV‐DNA levels at the start of TDF‐based rescue therapy were associated with higher VR.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25973716</pmid><doi>10.1111/jgh.12993</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of gastroenterology and hepatology, 2015-10, Vol.30 (10), p.1514-1521 |
| issn | 0815-9319 1440-1746 |
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| subjects | Adenine - analogs & derivatives Adult Antiviral Agents - administration & dosage chronic hepatitis B DNA, Viral - blood Drug Resistance, Multiple Drug Therapy, Combination Female Guanine - administration & dosage Guanine - analogs & derivatives Hepatitis B virus - genetics Hepatitis B, Chronic - drug therapy Hepatitis B, Chronic - virology Humans Lamivudine - administration & dosage Male Middle Aged multidrug resistance Multivariate Analysis Organophosphonates tenofovir Tenofovir - administration & dosage Treatment Failure |
| title | Tenofovir-based rescue therapy for chronic hepatitis B patients who had failed treatment with lamivudine, adefovir, and entecavir |
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