1007 Risk of Renal Toxicity With Tenofovir Df (Tdf) for Chronic Hepatitis B (Chb)

Gish, Robert G.; Mangahas, Michael; Baqai, Saad; Shaw, Rachel

doi:10.1016/s0168-8278(10)61008-2

Cited by 8 publications

(11 citation statements)

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“…Thus, renal function should be carefully monitored in these patients treated with TDF. DM and renal or liver transplantation are reported to be independent factors associated with renal function deterioration in patients treated with TDF …”

Section: Discussionmentioning

confidence: 99%

Three‐year efficacy and safety of tenofovir in nucleos(t)ide analog‐naïve and nucleos(t)ide analog‐experienced chronic hepatitis B patients

Wang

Hung

Lee

et al. 2016

J of Gastro and Hepatol

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Section: Discussionmentioning

confidence: 99%

Three‐year efficacy and safety of tenofovir in nucleos(t)ide analog‐naïve and nucleos(t)ide analog‐experienced chronic hepatitis B patients

Wang

Hung

Lee

et al. 2016

J of Gastro and Hepatol

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“…Improvement was greatest in patients more than 50 years old and those with abnormal baseline GFR; and was not associated with baseline ascites, virologic response or reduction in Child-Pugh score [27]. GFR improvement on telbivudine stands in contrast to the declines over time observed in studies of tenofovir [28] and entecavir [29]. Interestingly, GFR modeling data from Mauss et al.…”

Section: Discussionmentioning

confidence: 99%

52-Week Efficacy and Safety of Telbivudine with Conditional Tenofovir Intensification at Week 24 in HBeAg-Positive Chronic Hepatitis B

et al. 2013

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Background and AimsThe Roadmap concept is a therapeutic framework in chronic hepatitis B for the intensification of nucleoside analogue monotherapy based on early virologic response. The efficacy and safety of this approach applied to telbivudine treatment has not been investigated.MethodsA multinational, phase IV, single-arm open-label study (ClinicalTrials.gov ID NCT00651209) was undertaken in HBeAg-positive, nucleoside-naive adult patients with chronic hepatitis B. Patients received telbivudine (600 mg once-daily) for 24 weeks, after which those with undetectable serum HBV DNA (<300 copies/mL) continued to receive telbivudine alone while those with detectable DNA received telbivudine plus tenofovir (300 mg once-daily). Outcomes were assessed at Week 52.Results105 patients commenced telbivudine monotherapy, of whom 100 were included in the efficacy analysis. Fifty-five (55%) had undetectable HBV DNA at Week 24 and continued telbivudine monotherapy; 45 (45%) received tenofovir intensification. At Week 52, the overall proportion of undetectable HBV DNA was 93% (93/100) by last-observation-carried-forward analysis (100% monotherapy group, 84% intensification group) and no virologic breakthroughs had occurred. ALT normalization occurred in 77% (87% monotherapy, 64% intensification), HBeAg clearance in 43% (65% monotherapy, 16% intensification), and HBeAg seroconversion in 39% (62% monotherapy, 11% intensification). Six patients had HBsAg clearance. Myalgia was more common in the monotherapy group (19% versus 7%). No decrease in the mean glomerular filtration rate occurred in either treatment group at Week 52.ConclusionsTelbivudine therapy with tenofovir intensification at Week 24, where indicated by the Roadmap strategy, appears effective and well tolerated for the treatment of chronic hepatitis B.Trial RegistrationClinicalTrials.gov NCT00651209

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“…In comparison to nucleotide analogues, nucleoside analogues, such as ETV and LdT, show not significant renal toxicity [67,68] . Studies have been performed comparing ETV and TDF nephrotoxicity [82][83][84][85][86] . After 2 years of treatment, there was no significant modifications in eGFR in 74 ETV and 50 TDF ± LAM treated patients [82] .…”

Section: Term Definitionmentioning

confidence: 99%

“…In ETV treated patients, 3.8% of patients had a 25% increase in creatinine levels while 0.47% of TDF treated patients had a 25% decrease in eGFR after 12 mo of treatment [83] . In a community-based retrospective cohort study, 80 patients treated with TDF monotherapy or in combination with other NUCs were matched with 80 ETV treated patients and incidences of serum creatinine increments and eGFR decrease were evaluated [84,85] . More patients in the ETV group had creatinine increments ≥ 0.5 mg/dL (3 vs 11; P = 0.025), whereas more patients treated with TDF had eGFR reductions of < 60 mL/min (15 vs 6; P = 0.022) and at least 1 dose modification (13 vs 4; P = 0.021).…”

Section: Term Definitionmentioning

confidence: 99%

Antiviral treatment for chronic hepatitis B in renal transplant patients

Ridruejo

2014

WJH

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Chronic hepatitis B infection is frequent in renal transplant patients. It negatively impacts long term outcomes reducing graft and patient survival. Current guidelines clearly define who needs treatment, when to start, what is the first line therapy, how to monitor treatment response, when to stop, and how patients must be controlled for its safety. There is some data showing a favorable safety and efficacy profile of nucleos(t)ide analogue (NUC) treatment in the renal transplant setting. Entecavir, a drug without major signs of nephrotoxicity, appears to be the first option for NUC naïve patients and tenofovir remains the preferred choice for patients with previous resistance to lamivudine or any other NUC. Renal transplant recipients under antiHBV therapy should be monitored for its efficacy against HBV but also for its safety with a close renal monitoring. Studies including a large number of patients with long term treatment and follow up are still needed to better demonstrate the safety and efficacy of newer NUCs in this population. Core tip: Nucleos(t)ide analogue treatment is safe and effective in renal transplant patients. It improves long term patients and graft survival.Ridruejo E. Antiviral treatment for chronic hepatitis B in renal transplant patients.

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1007 Risk of Renal Toxicity With Tenofovir Df (Tdf) for Chronic Hepatitis B (Chb)

Cited by 8 publications

References 0 publications

Three‐year efficacy and safety of tenofovir in nucleos(t)ide analog‐naïve and nucleos(t)ide analog‐experienced chronic hepatitis B patients

Three‐year efficacy and safety of tenofovir in nucleos(t)ide analog‐naïve and nucleos(t)ide analog‐experienced chronic hepatitis B patients

52-Week Efficacy and Safety of Telbivudine with Conditional Tenofovir Intensification at Week 24 in HBeAg-Positive Chronic Hepatitis B

Antiviral treatment for chronic hepatitis B in renal transplant patients

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