Efficacy of telbivudine compared with entecavir in hepatitis B virus-related cirrhosis

2 year follow-up data

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background & Aims: Entecavir (ETV) is effective in the treatment of chronic hepatitis B virus (HBV) infections, even in patients with underlying cirrhosis. However, there is little information on the effect of telbivudine (TBV) in chronic hepatitis B patients with cirrhosis.This study compared the antiviral efficacy of TBV and ETV in HBV-related cirrhosis. Methods: We consecutively enrolled 151 treatment-naïve patients with HBV-related cirrhosis who started antiviral therapy with TBV (n = 61) or ETV (n = 90). Results: After 24 months of treatment, per-protocol analysis showed similar virological response rates (HBV DNA <20 IU/ml) in the TBV group (80.6%, 25/31) and in the ETV group (90.2%, 74/82) (P = 0.167). However, intention-to-treat analysis showed lower virological response rates in the TBV group (41.7%, 25/60) than in the ETV group (83.1%, 74/89) (P = 0.001). Mean reduction in HBV DNA levels was greater in the ETV group (-3.72 ± 1.94 vs. -4.87 ± 1.57 respectively, P = 0.001). Serologic and biochemical response rates at month 24 did not differ significantly between the groups. Child-Turcotte-Pugh score was significantly improved after 24 months compared to the pretreatment state without difference between the groups. During 24 months of therapy, 15 patients (27.3%) showed antiviral resistance to TBV while no resistance (0%) was reported in the ETV group (P = 0.001). Conclusions: Compared to ETV, TBV therapy shows lower efficacy in viral suppression and higher risk of antiviral resistance despite comparable effect on improvement of hepatic function for the treatment of HBV-related cirrhosis.

Original languageEnglish
Pages (from-to)860-869
Number of pages10
JournalLiver International
Volume35
Issue number3
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Hepatitis B virus
Fibrosis
Antiviral Agents
Chronic Hepatitis B
Therapeutics
Intention to Treat Analysis
entecavir
telbivudine
DNA
Virus Diseases
Clinical Protocols
Liver

Keywords

  • Cirrhosis
  • Entecavir
  • Hepatitis B
  • Telbivudine

ASJC Scopus subject areas

  • Hepatology

Cite this

@article{d808110e44cc4cf68f1bcaf6d170d00d,
title = "Efficacy of telbivudine compared with entecavir in hepatitis B virus-related cirrhosis: 2 year follow-up data",
abstract = "Background & Aims: Entecavir (ETV) is effective in the treatment of chronic hepatitis B virus (HBV) infections, even in patients with underlying cirrhosis. However, there is little information on the effect of telbivudine (TBV) in chronic hepatitis B patients with cirrhosis.This study compared the antiviral efficacy of TBV and ETV in HBV-related cirrhosis. Methods: We consecutively enrolled 151 treatment-na{\"i}ve patients with HBV-related cirrhosis who started antiviral therapy with TBV (n = 61) or ETV (n = 90). Results: After 24 months of treatment, per-protocol analysis showed similar virological response rates (HBV DNA <20 IU/ml) in the TBV group (80.6{\%}, 25/31) and in the ETV group (90.2{\%}, 74/82) (P = 0.167). However, intention-to-treat analysis showed lower virological response rates in the TBV group (41.7{\%}, 25/60) than in the ETV group (83.1{\%}, 74/89) (P = 0.001). Mean reduction in HBV DNA levels was greater in the ETV group (-3.72 ± 1.94 vs. -4.87 ± 1.57 respectively, P = 0.001). Serologic and biochemical response rates at month 24 did not differ significantly between the groups. Child-Turcotte-Pugh score was significantly improved after 24 months compared to the pretreatment state without difference between the groups. During 24 months of therapy, 15 patients (27.3{\%}) showed antiviral resistance to TBV while no resistance (0{\%}) was reported in the ETV group (P = 0.001). Conclusions: Compared to ETV, TBV therapy shows lower efficacy in viral suppression and higher risk of antiviral resistance despite comparable effect on improvement of hepatic function for the treatment of HBV-related cirrhosis.",
keywords = "Cirrhosis, Entecavir, Hepatitis B, Telbivudine",
author = "Kim, {Hae Rim} and Yim, {Hyung Joon} and Seonghee Kang and Suh, {Sang Jun} and Kim, {Seung Young} and Hyun, {Jong Jin} and Koo, {Ja Seol} and Kim, {Ji Hoon} and Seo, {Yeon Seok} and Yeon, {Jong Eun} and Lee, {Sang Woo} and Byun, {Kwan Soo} and Soon-Ho Um",
year = "2015",
month = "1",
day = "1",
doi = "10.1111/liv.12605",
language = "English",
volume = "35",
pages = "860--869",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Efficacy of telbivudine compared with entecavir in hepatitis B virus-related cirrhosis

T2 - 2 year follow-up data

AU - Kim, Hae Rim

AU - Yim, Hyung Joon

AU - Kang, Seonghee

AU - Suh, Sang Jun

AU - Kim, Seung Young

AU - Hyun, Jong Jin

AU - Koo, Ja Seol

AU - Kim, Ji Hoon

AU - Seo, Yeon Seok

AU - Yeon, Jong Eun

AU - Lee, Sang Woo

AU - Byun, Kwan Soo

AU - Um, Soon-Ho

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background & Aims: Entecavir (ETV) is effective in the treatment of chronic hepatitis B virus (HBV) infections, even in patients with underlying cirrhosis. However, there is little information on the effect of telbivudine (TBV) in chronic hepatitis B patients with cirrhosis.This study compared the antiviral efficacy of TBV and ETV in HBV-related cirrhosis. Methods: We consecutively enrolled 151 treatment-naïve patients with HBV-related cirrhosis who started antiviral therapy with TBV (n = 61) or ETV (n = 90). Results: After 24 months of treatment, per-protocol analysis showed similar virological response rates (HBV DNA <20 IU/ml) in the TBV group (80.6%, 25/31) and in the ETV group (90.2%, 74/82) (P = 0.167). However, intention-to-treat analysis showed lower virological response rates in the TBV group (41.7%, 25/60) than in the ETV group (83.1%, 74/89) (P = 0.001). Mean reduction in HBV DNA levels was greater in the ETV group (-3.72 ± 1.94 vs. -4.87 ± 1.57 respectively, P = 0.001). Serologic and biochemical response rates at month 24 did not differ significantly between the groups. Child-Turcotte-Pugh score was significantly improved after 24 months compared to the pretreatment state without difference between the groups. During 24 months of therapy, 15 patients (27.3%) showed antiviral resistance to TBV while no resistance (0%) was reported in the ETV group (P = 0.001). Conclusions: Compared to ETV, TBV therapy shows lower efficacy in viral suppression and higher risk of antiviral resistance despite comparable effect on improvement of hepatic function for the treatment of HBV-related cirrhosis.

AB - Background & Aims: Entecavir (ETV) is effective in the treatment of chronic hepatitis B virus (HBV) infections, even in patients with underlying cirrhosis. However, there is little information on the effect of telbivudine (TBV) in chronic hepatitis B patients with cirrhosis.This study compared the antiviral efficacy of TBV and ETV in HBV-related cirrhosis. Methods: We consecutively enrolled 151 treatment-naïve patients with HBV-related cirrhosis who started antiviral therapy with TBV (n = 61) or ETV (n = 90). Results: After 24 months of treatment, per-protocol analysis showed similar virological response rates (HBV DNA <20 IU/ml) in the TBV group (80.6%, 25/31) and in the ETV group (90.2%, 74/82) (P = 0.167). However, intention-to-treat analysis showed lower virological response rates in the TBV group (41.7%, 25/60) than in the ETV group (83.1%, 74/89) (P = 0.001). Mean reduction in HBV DNA levels was greater in the ETV group (-3.72 ± 1.94 vs. -4.87 ± 1.57 respectively, P = 0.001). Serologic and biochemical response rates at month 24 did not differ significantly between the groups. Child-Turcotte-Pugh score was significantly improved after 24 months compared to the pretreatment state without difference between the groups. During 24 months of therapy, 15 patients (27.3%) showed antiviral resistance to TBV while no resistance (0%) was reported in the ETV group (P = 0.001). Conclusions: Compared to ETV, TBV therapy shows lower efficacy in viral suppression and higher risk of antiviral resistance despite comparable effect on improvement of hepatic function for the treatment of HBV-related cirrhosis.

KW - Cirrhosis

KW - Entecavir

KW - Hepatitis B

KW - Telbivudine

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U2 - 10.1111/liv.12605

DO - 10.1111/liv.12605

M3 - Article

VL - 35

SP - 860

EP - 869

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 3

ER -