-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Author: Cai Hao East chief physician Beijing Ditan Hospital, the medical article is the author's permission Naomaitong release, please do not reprint without authorization.
Introduction I often receive letters from some patients, saying that I have been taking entecavir treatment and the virus has been suppressed very well, but the hepatitis B surface antigen (HBsAg) has not dropped and the drug cannot be stopped.
Now that Tenofovir Dipivoxil is available, would it be better to switch to Tenofovir Dipivoxil? Can it increase the chance of stopping the drug? It just so happened that I just saw a similar study by Inoue et al.
[1] in Japan and translated the main content for you to share.
Research introduction Research method This research comes from 4 hospitals in Japan, a total of 19 patients, all of whom have taken Entecavir for at least 1 year and have not developed drug resistance.
These patients were randomly divided into 2 groups at a 2:1 ratio.
12 patients switched to tenofovir dipivoxil (TDF group), and 7 patients continued entecavir (ETV group) treatment for 24 months of observation.
The results of the study were that the baseline demographic characteristics, blood routine, liver and kidney function, hepatitis B virology, degree of liver fibrosis, entecavir treatment time and previous treatment history of the two groups of patients were comparable.
At baseline, patients with serum HBV DNA levels below the lower limit of detection in the TDF group and ETV group were 11/12 (92%) and 5/7 (71%), respectively; at 12 months of treatment, the TDF group and ETV group were 11 /12 (92%) and 6/7 (86%); at 24 months, they were 12/12 (100%) and 6/7 (86%).
The average change of HBsAg quantification in the TDF group and the ETV group was -0.
25 log10 IU/ml and -0.
13 log10 IU/ml at 12 months of treatment, and -0.
25 log10 IU/ml and -0.
06 log10 IU/ at 24 months.
ml, the decline of HBsAg in the TDF group was greater, especially in the first 12 months of dressing change, but the difference was not statistically significant (Figure 1).Figure 1 The average change of HBsAg quantification in the TDF group and the ETV group The changes of alanine aminotransferase (ALT) in the two groups were basically similar (Figure 2).
Seven of the 19 patients were positive for hepatitis B e antigen (HBeAg), 2/4 (50%) HBeAg serum clearance in the TDF group, and 0/3 (0%) HBeAg serum clearance in the ETV group.
During the observation period, no patients developed liver cancer.
Figure 2 The average change of ALT between the TDF group and the ETV group There was no significant difference in the estimated glomerular filtration rate (eGFR) between the two groups (Figure 3).
The blood phosphorus level in the TDF group seemed to decrease, but the difference was not statistically significant at any time point (Figure 4).
It is worth noting that a 62-year-old male patient in the TDF group had a baseline blood phosphorus of 2.
6 mg/dl (0.
84 mmol/L), and hypophosphatemia [2.
0 mg/dl (0.
65 mmol/L) occurred after 12 months of treatment )], 6 months after switching to propofol tenofovir, blood phosphorus recovered to 2.
2 mg/dl (0.
71 mmol/L).
The data of this patient after the dressing change were not included in the analysis.
Fig.
3 The average change of eGFR in the TDF group and the ETV group Fig.
4 The summary of the average change in blood phosphorus in the TDF group and the ETV group According to the results of Inoue et al.
, I believe that entecavir-resistant chronic hepatitis B patients do not in general It is necessary to switch to tenofovir dipivoxil unless the HBV DNA response is poor or resistant.
It has been reported that tenofovir has a more significant effect on reducing HBsAg than entecavir[2,3], but in the results of Inoue et al.
, there is no significant difference in the decline of HBsAg between the two groups, which may also be related to the number of cases.
If a decrease in HBsAg is expected to change the treatment plan, it is recommended to switch to propofol tenofovir treatment.
References: [1]Inoue J, Akahane T, Kobayashi T, et al.
Switching to tenofovir disoproxil fumarate in entecavir-treated chronic hepatitis B patients: A pilot randomized controlled study[J].
Biomed Rep.
2021.
14(2) : 20.
[2]Kumada T, Toyoda H, Tada T, et al.
Comparison of the impact of tenofovir alafenamide and entecavir on declines of hepatitis B surface antigen levels[J].
Eur J Gastroenterol Hepatol.
2021.
32(2) : 255-260.
[3]Hagiwara S, Nishida N, Ida H, et al.
Switching from entecavir to tenofovir alafenamide versus maintaining entecavir for chronic hepatitis B[J].
J Med Virol.
2019.
91(10): 1804- 1810.
Introduction I often receive letters from some patients, saying that I have been taking entecavir treatment and the virus has been suppressed very well, but the hepatitis B surface antigen (HBsAg) has not dropped and the drug cannot be stopped.
Now that Tenofovir Dipivoxil is available, would it be better to switch to Tenofovir Dipivoxil? Can it increase the chance of stopping the drug? It just so happened that I just saw a similar study by Inoue et al.
[1] in Japan and translated the main content for you to share.
Research introduction Research method This research comes from 4 hospitals in Japan, a total of 19 patients, all of whom have taken Entecavir for at least 1 year and have not developed drug resistance.
These patients were randomly divided into 2 groups at a 2:1 ratio.
12 patients switched to tenofovir dipivoxil (TDF group), and 7 patients continued entecavir (ETV group) treatment for 24 months of observation.
The results of the study were that the baseline demographic characteristics, blood routine, liver and kidney function, hepatitis B virology, degree of liver fibrosis, entecavir treatment time and previous treatment history of the two groups of patients were comparable.
At baseline, patients with serum HBV DNA levels below the lower limit of detection in the TDF group and ETV group were 11/12 (92%) and 5/7 (71%), respectively; at 12 months of treatment, the TDF group and ETV group were 11 /12 (92%) and 6/7 (86%); at 24 months, they were 12/12 (100%) and 6/7 (86%).
The average change of HBsAg quantification in the TDF group and the ETV group was -0.
25 log10 IU/ml and -0.
13 log10 IU/ml at 12 months of treatment, and -0.
25 log10 IU/ml and -0.
06 log10 IU/ at 24 months.
ml, the decline of HBsAg in the TDF group was greater, especially in the first 12 months of dressing change, but the difference was not statistically significant (Figure 1).Figure 1 The average change of HBsAg quantification in the TDF group and the ETV group The changes of alanine aminotransferase (ALT) in the two groups were basically similar (Figure 2).
Seven of the 19 patients were positive for hepatitis B e antigen (HBeAg), 2/4 (50%) HBeAg serum clearance in the TDF group, and 0/3 (0%) HBeAg serum clearance in the ETV group.
During the observation period, no patients developed liver cancer.
Figure 2 The average change of ALT between the TDF group and the ETV group There was no significant difference in the estimated glomerular filtration rate (eGFR) between the two groups (Figure 3).
The blood phosphorus level in the TDF group seemed to decrease, but the difference was not statistically significant at any time point (Figure 4).
It is worth noting that a 62-year-old male patient in the TDF group had a baseline blood phosphorus of 2.
6 mg/dl (0.
84 mmol/L), and hypophosphatemia [2.
0 mg/dl (0.
65 mmol/L) occurred after 12 months of treatment )], 6 months after switching to propofol tenofovir, blood phosphorus recovered to 2.
2 mg/dl (0.
71 mmol/L).
The data of this patient after the dressing change were not included in the analysis.
Fig.
3 The average change of eGFR in the TDF group and the ETV group Fig.
4 The summary of the average change in blood phosphorus in the TDF group and the ETV group According to the results of Inoue et al.
, I believe that entecavir-resistant chronic hepatitis B patients do not in general It is necessary to switch to tenofovir dipivoxil unless the HBV DNA response is poor or resistant.
It has been reported that tenofovir has a more significant effect on reducing HBsAg than entecavir[2,3], but in the results of Inoue et al.
, there is no significant difference in the decline of HBsAg between the two groups, which may also be related to the number of cases.
If a decrease in HBsAg is expected to change the treatment plan, it is recommended to switch to propofol tenofovir treatment.
References: [1]Inoue J, Akahane T, Kobayashi T, et al.
Switching to tenofovir disoproxil fumarate in entecavir-treated chronic hepatitis B patients: A pilot randomized controlled study[J].
Biomed Rep.
2021.
14(2) : 20.
[2]Kumada T, Toyoda H, Tada T, et al.
Comparison of the impact of tenofovir alafenamide and entecavir on declines of hepatitis B surface antigen levels[J].
Eur J Gastroenterol Hepatol.
2021.
32(2) : 255-260.
[3]Hagiwara S, Nishida N, Ida H, et al.
Switching from entecavir to tenofovir alafenamide versus maintaining entecavir for chronic hepatitis B[J].
J Med Virol.
2019.
91(10): 1804- 1810.
