Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide
Luisa Roade 1 , Alessandro Loglio 2 , Marta Borghi 2 , Mar Riveiro-Barciela 1 , Roberta Soffredini 2 , Floriana Facchetti 2 , Dhanai di Paolo 2 , David Tabernero 3 , Giovanna Lunghi 4 , Rafael Esteban 1 , Maria Buti 5 , Pietro Lampertico 6
Affiliations
PMID: 32703729 DOI: 10.1016/j.dld.2020.06.037
Abstract
Background: To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir.
Aims: To estimate the number of patients who would benefit from a treatment switch in a real-life setting.
Methods: Consecutive hepatitis B patients receiving tenofovir-disoproxil before 31 December 2017 were enrolled in a cross-sectional study in two European hospitals. Clinical and virological data were recorded; renal function was assessed by estimated glomerular filtrate rate, serum phosphate and creatinine, proteinuria, and albuminuria; bone involvement by spine and femur DEXA scan.
Results: In total, 565 patients included: 62 (18-91) years, 75% males, 92% Caucasian, 92% HBeAg-negative, 40% cirrhotic. Fifty-five percent of patients fulfilled age criterion (>60 years). Older patients had higher rates of cirrhosis (51% vs 26%, p<0.001), cardiovascular disease, and renal impairment. Thirty-six percent of patients met renal criteria, more commonly NA-experienced individuals (35% vs 21%, p=0.001); 17% had bone disease. Overall, 66% of patients had at least one criterion (71% if NA-experienced), 8% all three criteria, 28% age and renal criteria.
Conclusions: Approximately two-thirds of patients receiving long-term tenofovir-disoproxil are candidates for an entecavir or tenofovir-alafenamide switch according to EASL recommendations.
Declaration of Competing Interest M. Buti and R. Esteban report grant support and/or consultancy and lecture fees from AbbVie, Gilead Sciences, Bristol-Myers Squibb, Janssen and MSD. M. Riveiro-Barciela reports lecture fees from Gilead Sciences. P.Lampertico is an Advisory Board/Speaker Bureau for BMS, Roche, Gilead Sciences, GSK, Abbvie, MSD, Arrowhead, Alnylam, Janssen, Spring Bank, Myr-pharma, Eiger. A. Loglio is a Speaker Bureau for Gilead Sciences, Myr-pharma. 作者: StephenW 时间: 2020-7-25 14:28