Pharmacotherapy. 2018 Aug 18. doi: 10.1002/phar.2174. [Epub ahead of print]
Tenofovir alafenamide (TAF) for the treatment of chronic hepatitis B mono-infection.
Childs-Kean LM1, Egelund E2, Jourjy J3.
Author information
1
University of Florida College of Pharmacy, Gainesville, FL, PO Box 100483, 32610, USA.
2
University of Florida College of Pharmacy, Jacksonville, FL, USA.
3
University of Florida College of Pharmacy, Orlando, FL, USA.
Abstract
Tenofovir alafenamide (TAF) is indicated for adult patients with chronic HBV infection with compensated liver disease at a dose of 25mg orally daily. TAF is a more stable prodrug in the plasma than tenofovir disoproxil fumarate (TDF), leading to decreased plasma exposure of tenofovir. Decreased exposure is thought to reduce the risk of long-term TDF toxicities, such as nephrotoxicity and decreased bone mineral density. TAF has the same mechanism of action as TDF: a nucleotide reverse transcriptase inhibitor. The results of Phase III primary trials and extensions showed that TAF is non-inferior to TDF at suppressing the HBV viral load in treatment naïve and treatment-experienced HBeAg-negative and HBeAg-positive patients at 48 weeks, 96 weeks, and 144 weeks of therapy. The most commonly reported adverse events were headache, abdominal pain, fatigue, cough, nausea, and back pain. At all evaluated time points (out to 144 weeks of treatment), patients who received TAF had less risk of nephrotoxicity and less of a decline in bone mineral density than the patients who received TDF. TAF appears to be safe in patients with a creatinine clearance above 15mL/min; however, TAF is not currently recommended in patients with an estimated creatinine clearance below this threshold. TAF is safe in patients with mild hepatic impairment, but is not currently recommended in patients with moderate or severe hepatic impairment (Child-Pugh Class B or C). This article is protected by copyright. All rights reserved.
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