- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
Abstract
Title | A European field study of the efficacy and safety of Tenofovir disoproxil fumarate (TDF) as monotherapy in patients with prior failure to other nucleoside/nucleotide analogues | Speaker: | Florian van Bömmel | Author: | F. van Bömmel1*, R. Zoutendijk2, R. de Man3, J.-P. Bronowiki4, K. Rutter5, P. Ferenci5, H. Janssen2, B. Fülöp1, A. Brodzinski1, J. Wiegand1, H. Wedemeyer6, K. Deterding6, A. Erhardt7, D. Hüppe8, M. Bourlière9, C. Sarrazin10, J. Trojan10, P. Buggisch11, J. Petersen11, U. Spengler12, A. Kamp13, S. Mauss13, M. Schuchmann14, K. van Nieuwkerk15, T. Gerlach16, D. Moradpour17, A. Schweinberger1, H. Wasmuth18, T. Berg1 | Affiliation: | 1Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Universitätsklinik Leipzig, Leipzig, Germany, 2Erasmus MC Rotterdam, 3Gastroenterology, Erasmus MC University Hospital, Rotterdam, The Netherlands, 4Service d'Hépato-Gastroentérologie, CHU de Nancy, Nancy, France, 5Medical University of Vienna, Vienna, Austria, 6Medizinische Hochschule Hannover, Hannover, 7Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, 8Gastroenterologische Gemeinschaftspraxis Herne, Herne, Germany, 9Hôpital St Joseph, Marseille, France, 10Johann Wolfgang Goethe University Medical Center, Frankfurt/Main, 11IFI Institut Asklepios Klinik St Georg, Hamburg, 12Universitätsklinikum Bonn, Bonn, 13Center for HIV and Hepatogastroenterology, Düsseldorf, 14Universitätsklinikum Mainz, Mainz, Germany, 15VU Medisch Centrum, Amsterdam, The Netherlands, 16Klinik Augustinum, München, Germany, 17Centre Hospitalier Universitaire Lausanne, Lausanne, Switzerland, 18University Hospital Aachen, Aachen, Germany. *[email protected] | Background: Monotherapy with tenofovir disoproxil fuarate (TDF) is effective in patients who are treatment naïve and in patients after failure to treatment with other nucleoside/nucleotide analogues (NUCs). In this study, we have assessed the efficacy of long term TDF treatment in patients with preceding failure to other NUCs in a real life setting.
Methods: Patients receiving monotherapy with TDF 245 mg per day after failure to other NUCs were identified in 22 European centres. Inclusion criteria were: age ≥ 18 years, duration of TDF treatment ≥ 6 months, re-increase of HBV DNA > 1 log10 from nadir during preceding NUC treatment, exclusion of non compliance as stated by the treating physician. HBV DNA was measured using a real time PCR based assay (Roche Amplicor, lower detection limit 400 copies/mL).
Results: 589 patients receiving monotherapy with TDF for a mean duration of 44±24 [range, 9-122] months after failure to NUC treatment were retrospectively analyzed in 18 European centers (mean age 44±13[range, 18-76] years, 74% male, 54% HBeAg positive). Pre-treatment included lamivudine (n=426), adefovir (n=374), telbivudine (n=13) and entecavir (n=16). HBV DNA levels decreased from 5.6±2.3 [2.8-10.3] to 2.6±13 [2.6-4.4] after 12 and to 2.6±0.9 [18-3.1] after 24 months, respectively. HBV DNA was detectable in 6 patients at months 24, all of them who had been pre-treated with ADV. No re-increase of HBV DNA levels > 1 log10 was observed. HBeAg and HBsAg losses was observed in 60 (20%) and 11 (2%, all HBeAg positive) patients after a mean duration of 12±12 [1-55] and 15±12 [range, 1-36] months, respectively. Mean glomerular filtration rates changed from 67±35 [34-124] to 63±55 [36-118] at months 24 (p=0.87). No patient with initial glomerular filtration rate > 50 ml/min showed a decrease to values < 50 ml/min. TDF treatment was stopped in one patient due to enteritis.
Conclusion: In a real life setting, TDF as monotherapy represents an effective and safe option for long term treatment for patients with prior failure to NUC treatment. |
|
|