Real-world data in my country adds evidence of renal safety of TAF

For medical professionals only, TAF has certain advantages in renal safety! During the long-term antiviral treatment of chronic hepatitis B (CHB), drug safety has always been one of the key issues that clinicians are concerned about
.

Tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide fumarate (TAF) are both prodrugs of tenofovir (TFV), both of which are recommended by domestic and foreign guidelines as CHB patients.
First-line antiviral therapy [1-4]
.

However, previous studies have shown that long-term TDF treatment is associated with proximal tubulopathy and Fanconi syndrome [5]
.

The international phase 3 clinical study of TAF showed that compared with TDF, TAF showed comparable virological response rate, higher alanine aminotransferase (ALT) normalization rate and better renal safety [6], but still need More real-world research data
.

At the recently concluded 72nd Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), our team presented a real-world study evaluating the renal safety of CHB patients treated with TDF and TAF
.

In addition, we also evaluated a sensitive biomarker for predicting early renal impairment, urinary neutrophil gelatinase-associated lipocalin (NGAL) [7]
.

This prospective study screened 90 patients with newly diagnosed CHB who were treated in Huashan Hospital from January 2019 to December 2019, of which 15 patients were excluded due to renal disease, hepatocellular carcinoma and failure to complete follow-up, and were finally included.
Seventy-five patients received TDF (n=39) or TAF (n=36) treatment according to their own wishes, and were followed up to 48 weeks
.

The study compared the changes of renal function indicators such as glomerular filtration rate (eGFR) and NGAL between the two groups at baseline and at 48 weeks of treatment
.

The results showed that at the 48th week of treatment, patients receiving TDF treatment had higher levels of urinary NGAL (7.
6 ng/mL vs.
5.
1 ng/mL, P=0.
040) and urinary β2-microglobulin (0.
22 mg/mL vs.
0.
17 mg/mL).
mL, P=0.
047) was significantly higher than that in patients receiving TAF
.

In addition to the changes in renal function indicators in the two groups at 48 weeks, compared with the baseline, after 48 weeks of TDF treatment, the patients' urine β2-microglobulin level increased by 0.
01 mg/mL, and the urine microalbumin level also increased.
0.
95 mg/mL higher
.

However, there was no significant difference in serum creatinine, serum β2-microglobulin and serum NGAL between the two groups
.

This real-world study suggests that TAF has certain advantages in renal safety, especially for proximal tubular function
.

In addition, our study also focused on the more sensitive biomarker NGAL
.

Previous studies have shown that in the urine of some patients with mild drug-induced renal impairment, NGAL increased significantly earlier than serum creatinine and β2-microglobulin [8]
.

In this study, we also observed that urinary NGAL is more sensitive than eGFR in predicting early renal damage, which also provides new ideas for early detection of renal damage in CHB patients and timely optimization of diagnosis and treatment
.

Review of the past: TAF can improve liver reserve function and glomerular filtration rate in patients with hepatitis B cirrhosis after TIPS treatment Author introduction References: [1]Terault NA, Lok ASF, McMahon BJ, et al.
diagnosis,and treatment of chronic hepatitis B:AASLD 2018 hepatitis B guidance[J].
Hepatology,2018,67(4):1560-1599.
[2]European Association For The Study Of The Liver.
EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J].
Journal of hepatology,2017,67(2):370-398.
[4]Sarin SK,Kumar M,Lau GK,et al.
Asian-Pacific clinical practice guidelines on the management of hepatitis B:a 2015 update[J].
Hepatology international,2016,10(1):1-98.
[4]Wang Guiqiang, Duan Zhongping.
Guidelines for the prevention and treatment of chronic hepatitis B (2019 edition)[J].
Liver,2019,24 (12):1335-1356[5]Fux CA,Christen A,Zgraggen S,et al.
Effect of tenofovir on renal glomerular and tubular function[J].
Aids,2007,21(11):1483-1485.
[6 ]Chan HLY, Fung S, Seto WK, et al.
Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of HBeAg-positive chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial.
lancet Gastroenterol Hepatol.
2016Nov;1(3):185–95.
[ 7] Xueyun Zhang1, Qiankun Hu2, Xiaoqin Liu1 and Yuxian Huang1, Real world comparison of renal safety in patients treated with tenofovir disoproxil fumarate vs tenofovir alafenamide for chronic hepatitis B.
AASLD 2021-post 799 [8] Wang Chao, Bai Yujie, Zhou Xiaobing , et al.
Research progress of urinary NGAL as a biomarker for drug-induced acute nephrotoxicity [J].
Drug Evaluation Research, 44(8): 1806-1810.
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Guidelines and cutting-edge information are welcome to pay attention to "Jizhiyi" Statement: This content is only aimed at Chinese medical and health professionals, and is intended to provide and only provide scientific information to medical and health professionals for personal learning and reference purposesXiaoqin Liu1 and Yuxian Huang1, Real world comparison of renal safety in patients treated with tenofovir disoproxil fumarate vs tenofovir alafenamide for chronic hepatitis B.
AASLD 2021-post 799[8] Wang Chao, Bai Yujie, Zhou Xiaobing, et al.
Urine NGAL as a drug Research progress on biomarkers of induced acute nephrotoxicity [J].
Drug Evaluation Research, 44(8):1806-1810.
For more latest literature, guidelines and cutting-edge information in the fields of infectious diseases, hepatitis and AIDS, please pay attention to "Ji" "Intelligent Medicine" statement: This content is only for Chinese medical and health professionals, and is intended to provide and only provide scientific information to medical and health professionals for personal learning and reference purposesXiaoqin Liu1 and Yuxian Huang1, Real world comparison of renal safety in patients treated with tenofovir disoproxil fumarate vs tenofovir alafenamide for chronic hepatitis B.
AASLD 2021-post 799[8] Wang Chao, Bai Yujie, Zhou Xiaobing, et al.
Urine NGAL as a drug Research progress on biomarkers of induced acute nephrotoxicity [J].
Drug Evaluation Research, 44(8):1806-1810.
For more latest literature, guidelines and cutting-edge information in the fields of infectious diseases, hepatitis and AIDS, please pay attention to "Ji" "Intelligent Medicine" statement: This content is only for Chinese medical and health professionals, and is intended to provide and only provide scientific information to medical and health professionals for personal learning and reference purposes
.

If you are not a healthcare professional, please do not participate or spread
.

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