Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea
As tenofovir disoproxil fumarate (TDF) requires long-term use, a reduction in bone density should be considered a possibility when treating patients with chronic hepatitis B (CHB) with aging and systemic diseases. Patients treated with tenofovir alafenamide (TAF) have improved bone mineral density l...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2023-12, Vol.58 (11-12), p.1185-1193 |
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| container_issue | 11-12 |
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| container_title | Alimentary pharmacology & therapeutics |
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| creator | Kim, Eunju Lee, Hyun Woong Kim, Soon Sun Yoon, Eileen Jang, Eun Sun Chang, Jong-In Cho, Young Youn Seo, Gi Hyeon Kim, Hyung Joon |
| description | As tenofovir disoproxil fumarate (TDF) requires long-term use, a reduction in bone density should be considered a possibility when treating patients with chronic hepatitis B (CHB) with aging and systemic diseases. Patients treated with tenofovir alafenamide (TAF) have improved bone mineral density loss compared to patients treated with TDF. Although improvements in bone density caused by TAF have been reported, studies on the actual reduction of fractures are insufficient.
To evaluate the impact of TAF on the risk of osteoporotic fractures in comparison with that of TDF.
Using the national claims data of the Health Insurance Review and Assessment Service, we conducted a retrospective cohort study of 32,582 patients with CHB who had been initially treated with TDF or TAF between November 2017 and December 2020. The numbers of patients treated with TDF and TAF were 20,877 and 11,705, respectively. The annual fracture rate per 100 patients in each group was calculated, and the Cox proportional hazard ratio (HR) was analysed after applying inverse probability treatment weights (IPTW) for both groups.
Among 32,582 patients, the average age was 47.8 ± 11.2 years, 64.5% were men, and the follow-up period was 24.4 ± 11.6 months. The incidence of osteoporotic fractures was 0.78 and 0.49 per 100 person-years in the TDF and TAF groups, respectively. After application of IPTW, the HR was 0.68 (95% confidence interval 0.55-0.85, p = 0.001).
TAF-treated patients with CHB had a significantly lower risk of osteoporotic fracture than TDF-treated patients. |
| doi_str_mv | 10.1111/apt.17716 |
| format | Article |
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To evaluate the impact of TAF on the risk of osteoporotic fractures in comparison with that of TDF.
Using the national claims data of the Health Insurance Review and Assessment Service, we conducted a retrospective cohort study of 32,582 patients with CHB who had been initially treated with TDF or TAF between November 2017 and December 2020. The numbers of patients treated with TDF and TAF were 20,877 and 11,705, respectively. The annual fracture rate per 100 patients in each group was calculated, and the Cox proportional hazard ratio (HR) was analysed after applying inverse probability treatment weights (IPTW) for both groups.
Among 32,582 patients, the average age was 47.8 ± 11.2 years, 64.5% were men, and the follow-up period was 24.4 ± 11.6 months. The incidence of osteoporotic fractures was 0.78 and 0.49 per 100 person-years in the TDF and TAF groups, respectively. After application of IPTW, the HR was 0.68 (95% confidence interval 0.55-0.85, p = 0.001).
TAF-treated patients with CHB had a significantly lower risk of osteoporotic fracture than TDF-treated patients.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.17716</identifier><identifier>PMID: 37694558</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adenine - adverse effects ; Adult ; Aging ; Alanine - adverse effects ; Bone density ; Bone mineral density ; Female ; Fractures ; Hepatitis ; Hepatitis B ; Hepatitis B, Chronic - drug therapy ; Humans ; Male ; Middle Aged ; Osteoporosis ; Osteoporotic Fractures - chemically induced ; Osteoporotic Fractures - epidemiology ; Osteoporotic Fractures - prevention & control ; Retrospective Studies ; Tenofovir ; Tenofovir - adverse effects</subject><ispartof>Alimentary pharmacology & therapeutics, 2023-12, Vol.58 (11-12), p.1185-1193</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><rights>Copyright © 2023 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-9de2c647594992a2515913a8f49e8efa24d932af381d5fc9847c3551bb22305e3</citedby><cites>FETCH-LOGICAL-c348t-9de2c647594992a2515913a8f49e8efa24d932af381d5fc9847c3551bb22305e3</cites><orcidid>0000-0002-3620-8175 ; 0000-0002-6862-1896 ; 0000-0002-6958-3035</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37694558$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Eunju</creatorcontrib><creatorcontrib>Lee, Hyun Woong</creatorcontrib><creatorcontrib>Kim, Soon Sun</creatorcontrib><creatorcontrib>Yoon, Eileen</creatorcontrib><creatorcontrib>Jang, Eun Sun</creatorcontrib><creatorcontrib>Chang, Jong-In</creatorcontrib><creatorcontrib>Cho, Young Youn</creatorcontrib><creatorcontrib>Seo, Gi Hyeon</creatorcontrib><creatorcontrib>Kim, Hyung Joon</creatorcontrib><title>Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>As tenofovir disoproxil fumarate (TDF) requires long-term use, a reduction in bone density should be considered a possibility when treating patients with chronic hepatitis B (CHB) with aging and systemic diseases. Patients treated with tenofovir alafenamide (TAF) have improved bone mineral density loss compared to patients treated with TDF. Although improvements in bone density caused by TAF have been reported, studies on the actual reduction of fractures are insufficient.
To evaluate the impact of TAF on the risk of osteoporotic fractures in comparison with that of TDF.
Using the national claims data of the Health Insurance Review and Assessment Service, we conducted a retrospective cohort study of 32,582 patients with CHB who had been initially treated with TDF or TAF between November 2017 and December 2020. The numbers of patients treated with TDF and TAF were 20,877 and 11,705, respectively. The annual fracture rate per 100 patients in each group was calculated, and the Cox proportional hazard ratio (HR) was analysed after applying inverse probability treatment weights (IPTW) for both groups.
Among 32,582 patients, the average age was 47.8 ± 11.2 years, 64.5% were men, and the follow-up period was 24.4 ± 11.6 months. The incidence of osteoporotic fractures was 0.78 and 0.49 per 100 person-years in the TDF and TAF groups, respectively. After application of IPTW, the HR was 0.68 (95% confidence interval 0.55-0.85, p = 0.001).
TAF-treated patients with CHB had a significantly lower risk of osteoporotic fracture than TDF-treated patients.</description><subject>Adenine - adverse effects</subject><subject>Adult</subject><subject>Aging</subject><subject>Alanine - adverse effects</subject><subject>Bone density</subject><subject>Bone mineral density</subject><subject>Female</subject><subject>Fractures</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Osteoporosis</subject><subject>Osteoporotic Fractures - chemically induced</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Osteoporotic Fractures - prevention & control</subject><subject>Retrospective Studies</subject><subject>Tenofovir</subject><subject>Tenofovir - adverse effects</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctuFDEQRS1ERIbAgh9AltjAohM_2m2bXYh4iUhZENYtj7uscei2Gz8S8kv5SjwkZEFtSlU6dVW6F6FXlBzTVidmLcdUSjo8QRvKB9ExwoenaEPYoDumKD9Ez3O-IoQMkrBn6JDLQfdCqA26u4QQXbz2CU8-xzXF337Gri4mmQL4GlKuGZdHyMzGQTCLnwDHgJPPP3F0OOYCcY0pFm-xS8aWmgD7gFdTPISS8Y0vO2x3KYZG7GC_Lz7jD-_xKQ5tiOFmr2ln45eMc6nT7f7-e6zt7ltMYF6gA2fmDC8f-hH68enj5dmX7vzi89ez0_PO8l6VTk_A7NBLoXutmWGCCk25Ua7XoMAZ1k-aM-O4opNwVqteWi4E3W4Z40QAP0Jv73WbGb8q5DIuPluYZxMg1jwyNTT_pGKyoW_-Q69iTaF91yjNtZA90Y16d0_ZFHNO4MY1-Wbw7UjJuA9wbAGOfwNs7OsHxbpdYHok_yXG_wDRB5lW</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Kim, Eunju</creator><creator>Lee, Hyun Woong</creator><creator>Kim, Soon Sun</creator><creator>Yoon, Eileen</creator><creator>Jang, Eun Sun</creator><creator>Chang, Jong-In</creator><creator>Cho, Young Youn</creator><creator>Seo, Gi Hyeon</creator><creator>Kim, Hyung Joon</creator><general>Wiley Subscription Services, Inc</general><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>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3620-8175</orcidid><orcidid>https://orcid.org/0000-0002-6862-1896</orcidid><orcidid>https://orcid.org/0000-0002-6958-3035</orcidid></search><sort><creationdate>202312</creationdate><title>Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea</title><author>Kim, Eunju ; Lee, Hyun Woong ; Kim, Soon Sun ; Yoon, Eileen ; Jang, Eun Sun ; Chang, Jong-In ; Cho, Young Youn ; Seo, Gi Hyeon ; Kim, Hyung Joon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-9de2c647594992a2515913a8f49e8efa24d932af381d5fc9847c3551bb22305e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenine - adverse effects</topic><topic>Adult</topic><topic>Aging</topic><topic>Alanine - adverse effects</topic><topic>Bone density</topic><topic>Bone mineral density</topic><topic>Female</topic><topic>Fractures</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Osteoporosis</topic><topic>Osteoporotic Fractures - chemically induced</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Osteoporotic Fractures - prevention & control</topic><topic>Retrospective Studies</topic><topic>Tenofovir</topic><topic>Tenofovir - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Eunju</creatorcontrib><creatorcontrib>Lee, Hyun Woong</creatorcontrib><creatorcontrib>Kim, Soon Sun</creatorcontrib><creatorcontrib>Yoon, Eileen</creatorcontrib><creatorcontrib>Jang, Eun Sun</creatorcontrib><creatorcontrib>Chang, Jong-In</creatorcontrib><creatorcontrib>Cho, Young Youn</creatorcontrib><creatorcontrib>Seo, Gi Hyeon</creatorcontrib><creatorcontrib>Kim, Hyung Joon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Eunju</au><au>Lee, Hyun Woong</au><au>Kim, Soon Sun</au><au>Yoon, Eileen</au><au>Jang, Eun Sun</au><au>Chang, Jong-In</au><au>Cho, Young Youn</au><au>Seo, Gi Hyeon</au><au>Kim, Hyung Joon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2023-12</date><risdate>2023</risdate><volume>58</volume><issue>11-12</issue><spage>1185</spage><epage>1193</epage><pages>1185-1193</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>As tenofovir disoproxil fumarate (TDF) requires long-term use, a reduction in bone density should be considered a possibility when treating patients with chronic hepatitis B (CHB) with aging and systemic diseases. Patients treated with tenofovir alafenamide (TAF) have improved bone mineral density loss compared to patients treated with TDF. Although improvements in bone density caused by TAF have been reported, studies on the actual reduction of fractures are insufficient.
To evaluate the impact of TAF on the risk of osteoporotic fractures in comparison with that of TDF.
Using the national claims data of the Health Insurance Review and Assessment Service, we conducted a retrospective cohort study of 32,582 patients with CHB who had been initially treated with TDF or TAF between November 2017 and December 2020. The numbers of patients treated with TDF and TAF were 20,877 and 11,705, respectively. The annual fracture rate per 100 patients in each group was calculated, and the Cox proportional hazard ratio (HR) was analysed after applying inverse probability treatment weights (IPTW) for both groups.
Among 32,582 patients, the average age was 47.8 ± 11.2 years, 64.5% were men, and the follow-up period was 24.4 ± 11.6 months. The incidence of osteoporotic fractures was 0.78 and 0.49 per 100 person-years in the TDF and TAF groups, respectively. After application of IPTW, the HR was 0.68 (95% confidence interval 0.55-0.85, p = 0.001).
TAF-treated patients with CHB had a significantly lower risk of osteoporotic fracture than TDF-treated patients.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37694558</pmid><doi>10.1111/apt.17716</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3620-8175</orcidid><orcidid>https://orcid.org/0000-0002-6862-1896</orcidid><orcidid>https://orcid.org/0000-0002-6958-3035</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2023-12, Vol.58 (11-12), p.1185-1193 |
| issn | 0269-2813 1365-2036 |
| language | eng |
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| source | MEDLINE; Wiley Journals |
| subjects | Adenine - adverse effects Adult Aging Alanine - adverse effects Bone density Bone mineral density Female Fractures Hepatitis Hepatitis B Hepatitis B, Chronic - drug therapy Humans Male Middle Aged Osteoporosis Osteoporotic Fractures - chemically induced Osteoporotic Fractures - epidemiology Osteoporotic Fractures - prevention & control Retrospective Studies Tenofovir Tenofovir - adverse effects |
| title | Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea |
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