Yonsei Med J.  2018 May;59(3):383-388. 10.3349/ymj.2018.59.3.383.

Real World Experience of Telbivudine Versus Entecavir in Patients with Chronic Hepatitis B, Including Long-Term Outcomes after Treatment Modification

• Choi JW
• Kim SH
• Seo JH
• Cho YS
• Won SY
• Park BK
• Jeon HH
• Lee YK
• Lee CK

• KMID: 2407861
• DOI: http://doi.org/10.3349/ymj.2018.59.3.383

Abstract

PURPOSE
To estimate long-term outcomes after treatment modification in patients with chronic hepatitis B (CHB) treated with entecavir (ETV) and telbivudine (LdT).
MATERIALS AND METHODS
The study enrolled 131 nucleos(t)ide analogue (NA)-naïve CHB patients treated with ETV or LdT. During the 3-year study, NA treatment history including the incidence, the type of treatment modification, reasons for the modification, and overall complete virologic response (CVR) rate were retrospectively evaluated using the patients' medical records.
RESULTS
Among the 131 patients, 84 and 47 were initially treated with ETV and LdT, respectively. During the course of 3-year study, 82 patients in the ETV group (97.6%) maintained initial treatment whereas only 19 in the LdT group (40.4%). In the LdT group, 26 patients (92.9%) switched to another NA and another NA was added in 2 (7.1%) patients. An assessment of the CVR rate at 3 years, including treatment modification, showed that 89.3% and 95.7% of patients in the ETV and LdT groups, respectively, had undetectable serum hepatitis B virus DNA levels (p=0.329). Among LdT patients with treatment modification, the cumulative incidence rate of a CVR for rescue therapy was significantly higher in the tenofovir than in the ETV group (p=0.009).
CONCLUSION
During the 3-year study, there were no significant differences in the CVR between the ETV and LdT groups if appropriate rescue therapy was considered.

Keyword

Entecavir; telbivudine; tenofovir; chronic hepatitis B

MeSH Terms

DNA
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Incidence
Medical Records
Retrospective Studies
Tenofovir
DNA
Tenofovir

Figure

• 

  Fig. 1 Flow diagram of the 3-years study. ETV, entecavir; LdT, telbivudine; NA, nucleos(t)ide analogue; CVR, complete virologic response; PVR, partial virologic response.

• 

  Fig. 2 Cumulative incidence of CVR and ALT normalization in response to ETV and LdT including treatment modification. (A) Cumulative incidence of CVR in patients with CHB. (B) Cumulative incidence of ALT normalization in patients with CHB. CVR, complete virologic response; ALT, alanine aminotransferase; ETV, entecavir; LdT, telbivudine; HBV, hepatitis B virus.

• 

  Fig. 3 Cumulative incidence of a CVR according to ETV and TDF as rescue therapy in patients with initial telbivudine therapy. CVR, complete virologic response; ETV, entecavir; TDF, tenofovir.

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