Telbivudine v Entecavir

StephenW

J Antimicrob Chemother. 2011 Dec 15. [Epub ahead of print]
A comparison of telbivudine and entecavir for chronic hepatitis B in
real-world clinical practice.
Source:
http://www.ncbi.nlm.nih.gov/pubmed/22174039
Tsai MC, Lee CM, Chiu KW, Hung
CH, Tung WC, Chen CH, Tseng PL, Chang KC, Wang JH, Lu SN, Yen YH, Hu TH.
Source
Division of Hepato-Gastroenterology, Department of Internal Medicine,
Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College
of Medicine, 123, Ta-Pei Road, Niao Sung District, Kaohsiung City, 833,
Taiwan.

Abstract
OBJECTIVES: To evaluate the efficacy of telbivudine and entecavir in
chronic hepatitis B (CHB) patients over a 1 year period.

METHODS: Ninety-seven telbivudine-naive and 98 entecavir-naive CHB patients
who had been treated for at least 1 year were enrolled. Serial serum
hepatitis B virus (HBV) DNA levels were checked at baseline and at weeks 24
and 48 after treatment.

RESULTS: Entecavir and telbivudine groups had similar baseline HBV DNA
levels (5.9?±?1.7 versus 6.0?±?1.5 log copies/mL, P?=?0.529). The
undetectable rate of HBV DNA after 1 year of treatment was significantly
higher in the entecavir group than the telbivudine group (94.9% versus
82.0%, P?=?0.009). Resistance developed in 6.7% of the telbivudine-naive
patients after 1 year compared with none of the entecavir-naive patients
(P?=?0.009). However, there was a significant difference between the
telbivudine and entecavir groups in hepatitis B e antigen (HBeAg)
seroconversion 24 weeks after treatment (40% versus 12.5%, P?=?0.007).
Multiple logistic regression analysis revealed that baseline alanine
aminotransferase (ALT) >200 IU/L (P?=?0.008) was independently associated
with HBeAg seroconversion. Applying the roadmap concept with ALT >2× upper
limit of normal at baseline, telbivudine and entecavir had favourable
outcomes in PCR negativity, ALT normalization, HBeAg seroconversion and
resistance.

CONCLUSIONS: In real-world clinical practice, telbivudine resulted in
higher rates of HBeAg seroconversion and drug resistance at week 48
compared with entecavir. A combination with baseline ALT plus 24 week HBV
DNA levels led to the lowest rates of resistance in HBeAg-positive
telbivudine-naive patients and had the highest probability of HBeAg
seroconversion in both entecavir- and telbivudine-naive patients.

StephenW

J抗菌化学方法。 2011年12月15日。 [检索提前打印]
一个治疗慢性乙型肝炎的比较替比夫定和恩替卡韦
现实世界中的临床实践。来源：
http://www.ncbi.nlm.nih.gov/pubmed/22174039仔MC，李CM，邱千瓦，洪
曾CH，东通道，卫生间，陈PL，张KC，王江海，陆松，日元YH，胡TH。
SourceDivision的肝，胃肠病，内科，
高雄长庚医院及长庚大学，学院
医学，茑成区，高雄市，833，123，大培路，
台湾。

摘要
目的：评价替比夫定和恩替卡韦的疗效
慢性乙型肝炎（CHB）患者超过1年的时间内。

方法：将90恩替卡韦天真七个替比夫定的幼稚和98例慢性乙型肝炎患者
至少1年的治疗已被纳入。串行血清
B型肝炎病毒（HBV）DNA水平基线和24周检查
治疗后48。

结果：恩替卡韦和替比夫定组也有类似的基线HBV DNA
水平（5.9 ±？1.7与6.0 ± 1.5日志拷贝/毫升，P = 0.529）。 “
治疗1年后的HBV DNA检测不到率显着
替比夫定组高于恩替卡韦组（94.9％比
82.0％，P = 0.009）。电阻在6.7％的替比夫定天真开发
1年后的患者相比，没有恩替卡韦，初治患者
（P = 0.009）。然而，有显著差异之间的
替比夫定和恩替卡韦组乙型肝炎e抗原（HBeAg的）
治疗24周后，血清转换（40％与12.5％，P =？0.007）。
多元Logistic回归分析显示，基线丙氨酸
转氨酶（ALT）> 200 IU / L（P = 0.008）独立相关
HBeAg血清转换。应用路线图的概念与ALT> 2 ×上层
在基线正常的限制，替比夫定和恩替卡韦具有良好的
结果在PCR阴性，ALT正常化，HBeAg血清转换和
阻力。

结论：在现实世界中的临床实践中，替比夫定导致
48周时的HBeAg血清转换和耐药率较高
而恩替卡韦。与基线ALT加24周乙肝病毒的组合
DNA水平，HBeAg阳性导致的电阻率最低的
替比夫定，初治患者和HBeAg的概率最高
两个天真的恩替卡韦和替比夫定的患者血清转化。