Expert Opin Drug Metab Toxicol. 2017 Dec 13. doi: 10.1080/17425255.2018.1417983. [Epub ahead of print]
Pharmacokinetic evaluation of besifovir for the treatment of HBV infection.Mak LY1, Seto WK1,2, Lai CL1,2, Yuen MF1,2. Author information 1a Department of Medicine , The University of Hong Kong, Queen Mary Hospital , Hong Kong.2b State Key Laboratory for Liver Research , The University of Hong Kong , Hong Kong.
AbstractBesifovir (LB80380) is a relatively new oral acyclic nucleotide phosphonate. We reviewed the pharmacokinetic characteristics of LB80380 and discussed its role in the treatment of chronic hepatitis B infection. Areas covered: LB80380 is a prodrug of LB80331 and LB8031. It is rapidly absorbed when taken orally. Escalating doses of besifovir produce linear increase of the plasma concentration. Doses above 60mg are effective for inhibiting HBV in human. Using 60mg as an example, the maximal concentration of LB80331 in plasma is 397 ng/mL. The time required to reach maximal concentration in plasma and elimination half-life are 2.0 and 3.0 hours, respectively. Besifovir and its metabolites are mainly excreted via the kidneys. Its antiviral efficacy is non-inferior to ETV 0.5mg daily. It is generally safe in terms of renal and bone toxicity. The most common adverse event is carnitine depletion which affects almost all patients on besifovir requiring carnitine supplementation. Expert opinion: Besifovir demonstrated predictable pharmacokinetic characteristics in human subjects. Few clinical studies on besifovir have been conducted. More data are expected particularly for special populations. The adverse events upon long term exposure should be monitored. Large scale head-to-head trials comparing besifovir with existing NA, especially tenofovir alafenamide, should be conducted.