标题: [Telbivudine]Clinical features and risk factors of creatine kinase elevations an [打印本页] 作者: StephenW 时间: 2010-12-29 09:54 标题: [Telbivudine]Clinical features and risk factors of creatine kinase elevations an
Journal of Viral Hepatitis
Early View (Articles online in advance of print)
Summary. With the extensive use of telbivudine, more and more studies
reported its association with creatine kinase (CK) elevations and myopathy.
However, clinical features of these adverse effects were poorly understood. The
aim of the present study was to investigate the clinical features and risk
factors of CK elevations and myopathy associated with telbivudine. The serum CK
levels of 200 patients who were treated with telbivudine for chronic hepatitis B
(CHB) between January 2007 and July 2010 were monitored and analysed along with
clinical manifestations. The 3-year cumulative incidence of CK elevations and
myopathy was 84.3% and 5%, respectively. CK elevations occurred more frequently
in men than in women, and patients aged ≤45 years and with negative HBeAg had
higher incidence of CK elevations. There was no difference in CK elevations
among patients with different HBV DNA levels. Male, younger age and HBeAg
negativity were independent predictors of CK elevations by multivariate Cox
regression analysis. There was no association between the occurrence of myopathy
and variables including age, sex, HBeAg and HBV DNA. No risk factors of myopathy
were identified. CK elevations usually occurred 21 months after starting
treatment, and most patients resolved spontaneously without interruption of
telbivudine therapy except three patients who had to switch to other agents. In
conclusion, CK elevations are common adverse reactions associated with
telbivudine therapy, while myopathy is rare. Male, younger age and HBeAg
negativity might be risk factors of CK elevations.