Tenofovir disoproxil fumarate therapy in patients with chronic hepatitis B and advanced fibrosis or compensated cirrhosis

Huiying Rao , Jia Shang , Qing Xie , Jianqi Lian , Pujun Gao , Junping Shi , Xinyue Chen , Jiefei Wang , Min Xu , Liaoyun Zhang , Yingren Zhao , Qing Mao , Maorong Wang , Wei Zhao , Zong Zhang , Jidong Jia , Hong Tang , Jiming Zhang , Xin Zheng , Chang Liu , Lai Wei
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Abstract

Background and aims

Tenofovir disoproxil fumarate (TDF) is the first-line therapy for chronic hepatitis B. This interim analysis presents the efficacy and safety data for TDF at Week 144 in patients with chronic hepatitis B and advanced fibrosis or compensated cirrhosis from China.

Methods

Patients were assessed for incidence of newly diagnosed hepatocellular carcinoma (HCC) and disease progression, liver stiffness measurement (LSM), virological suppression (serum hepatitis B virus DNA <20 IU/mL), alanine aminotransferase normalization, hepatitis B e antigen (HBeAg) loss and seroconversion, histological liver fibrosis score, and safety at Week 144.

Results

Overall, 197 patients were enrolled. At Week 144, the incidence of newly diagnosed HCC was observed in 2.1% patients, and the incidence of disease progression was observed in 3.6% patients. The mean (standard deviation) change in LSM from baseline was −5.1 (5.85) kPa. Serum hepatitis B virus DNA <20 IU/mL was observed in 94.1% patients, alanine aminotransferase normalization in 33.5% patients, HBeAg loss in 35.6% patients, and HBeAg seroconversion in 14.4% patients. Among patients with stage F3 or F4 fibrosis at baseline by LSM, 38.3% patients regressed to stage F0/1, and 22.0% of patients regressed to stage F2 at Week 144. Overall, 67.7% patients experienced ≥1 adverse events, 13.8% patients experienced TDF-related adverse events, and 16.4% patients experienced serious (none were TDF-related).

Conclusions

At Week 144 of TDF treatment, low incidence of HCC and disease progression were reported. Virological suppression was observed in 94.1% patients, which was associated with fibrosis regression. No new safety events were identified.

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替诺福韦二吡呋酯富马酸治疗慢性乙型肝炎和晚期纤维化或代偿性肝硬化患者
背景和目的富马酸替诺福韦(TDF)是慢性乙型肝炎的一线治疗药物。这项中期分析显示了TDF在中国慢性乙型肝炎合并晚期纤维化或代偿性肝硬化患者第144周的疗效和安全性数据。方法在第144周评估患者新诊断的肝细胞癌(HCC)发生率和疾病进展、肝硬度测量(LSM)、病毒学抑制(血清乙型肝炎病毒DNA和lt;20 IU/mL)、丙氨酸转氨酶正常化、乙型肝炎e抗原(HBeAg)丢失和血清转化、组织学肝纤维化评分和安全性。结果共纳入197例患者。在第144周时,新诊断的HCC发生率为2.1%,疾病进展发生率为3.6%。LSM与基线的平均(标准差)变化为- 5.1 (5.85)kPa。94.1%的患者血清乙型肝炎病毒DNA≥20 IU/mL, 33.5%的患者血清丙氨酸转氨酶正常,35.6%的患者血清HBeAg丢失,14.4%的患者血清HBeAg转化。在LSM基线为F3或F4期纤维化的患者中,38.3%的患者在第144周回归到F0/1期,22.0%的患者回归到F2期。总体而言,67.7%的患者出现≥1次不良事件,13.8%的患者出现与tdf相关的不良事件,16.4%的患者出现严重不良事件(没有一例与tdf相关)。结论TDF治疗第144周,HCC发病率低,病情进展。94.1%的患者出现病毒学抑制,与纤维化消退相关。没有发现新的安全事件。
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