Greater HBV DNA Reductions Seen within the First Two Weeks of Therapy with Telbivudine
By Marina N?ez, MD, PhD
Telbivudine (LdT), a novel nucleoside analogue under development for the treatment of hepatitis B has demonstrated better suppression of HBV replication than lamivudine (3TC) at 52 weeks of treatment in a phase IIb trial. In a further analysis, investigators from Idenix Pharmaceuticals and from the University of Hong Kong, studied HBV viral dynamics within the first 12 weeks of LdT therapy.
In this study, different dosages of LdT in monotherapy or combined with 3TC, were compared with 3TC monotherapy. According to a biphasic exponential model, the second phase HBV decline was faster, with a median estimated infected cell clearance rate constant of 0.06 in the LdT arms vs. 0.04hr-1 in the 3TC arm. The estimated infected cell half-life was of 12.1 vs. 19.4 days for the LdT-containg arms and the 3TC-monotherapy arm (p<0.001).
Therefore, the difference in HBV suppression between the LdT-containing arms and the 3TC-monotherapy arm at week 52, was seen as soon as within the first two weeks of therapy.
However, in the combined arms the HBV did not clear any faster than in the LdT monotherapy groups, challenging the approach of multiple nucleoside analogue therapy for the treatment of HBV.
11/05/04 Reference
X J Zhou and others.. HBV viral dynamics in a comparative trial of telbivudine (LdT), lamivudine, and the combination in patients with chronic hepatitis B. Abstract V-1155. 44th ICAAC. |