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Comparison of clinical efficacy and renal safety of telbivudine and entecavir in chronic hepatitis B patients receiving cytotoxic chemotherapy
Author(s) -
Law SiuTong,
Lee Ming Kai,
Lee Ann Shing,
Tung Yuk,
Li Kin Kong
Publication year - 2016
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12349
Subject(s) - entecavir , medicine , telbivudine , chemoprophylaxis , gastroenterology , hepatitis b , chemotherapy , renal function , hepatitis b virus , immunology , lamivudine , virus
Objective Limited data is available on the 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) who received cytotoxic chemotherapy. Methods Altogether 290 treatment‐naïve CHB patients undergoing intense chemotherapy were enrolled to receive daily 600 mg of LdT or 0.5 mg of ETV as pre‐emptive antiviral chemoprophylaxis. Results The ETV group had significantly higher proportion of patients with undetectable hepatitis B viral (HBV) DNA load compared with LdT at week 24 (73.0% vs 50.3%, 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 of therapy, respectively ( P = 0.059), which was associated with detectable HBV DNA at week 24 ( P = 0.000). The MELD score of the LdT group was significantly lower than that of the ETV group after the first year (4.53 vs 7.53, P = 0.002) and the second year (1.96 vs 7.09, P = 0.000) of antiviral therapy. Moreover, the estimated glomerular filtration rate (eGFR) was significantly improved in the LdT group than in the ETV group after two years of antiviral therapy. Conclusion LdT has a lower clinical efficacy in viral suppression than ETV, but LdT is associated with greater extent of improvement in liver and renal functions of patients in pre‐emptive prophylaxis for cytotoxic chemotherapy.