Efficacy of telbivudine compared with entecavir in hepatitis B virus‐related cirrhosis: 2 year follow‐up data. (5th July 2014)

• Record Type: Journal Article
• Authors: Kim, Hae Rim; Yim, Hyung Joon; Kang, Seonghee; Suh, Sang Jun; Kim, Seung Young; Hyun, Jong Jin; Koo, Ja Seol; Kim, Ji Hoon; Seo, Yeon Seok; Yeon, Jong Eun; Lee, Sang Woo; Byun, Kwan Soo; Um, Soon Ho
• Is Part Of: Liver international. Volume 35:Number 3(2015:Mar.)
• Page Start: 860
• Page End: 869
• Publication Date: 2014-07-05
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12605
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12605-abs-0001"> <title>Abstract</title> <sec id="liv12605-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>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.</p> </sec> <sec id="liv12605-sec-0002" sec-type="section"> <title>Methods</title> <p>We consecutively enrolled 151 treatment‐naïve patients with HBV‐related cirrhosis who started antiviral therapy with TBV (n = 61) or ETV (n = 90).</p> </sec> <sec id="liv12605-sec-0003" sec-type="section"> <title>Results</title> <p>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) (<italic>P </italic>=<italic> </italic>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) (<italic>P </italic>=<italic> </italic>0.001). Mean reduction in HBV DNA levels was greater in the ETV group (−3.72 ± 1.94 vs. −4.87 ± 1.57 respectively, <italic>P </italic>=<italic> </italic>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 (<italic>P </italic>=<italic> </italic>0.001).</p> </sec> <sec id="liv12605-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>