替诺福韦艾拉酚胺（TAF）治疗HBV，有哪些尚未解决的问题？

StephenW

Expert Rev Anti Infect Ther. 2018 Jan 17. doi: 10.1080/14787210.2018.1428561. [Epub ahead of print]
Tenofovir alafenamide (TAF) treatment of HBV, what are the unanswered questions?
Viganò M1, Loglio A2, Grossi G2, Lampertico P2.
Author information

1
    a Division of Hepatology, Ospedale San Giuseppe , Università degli Studi di Milano , Milan , Italy.
2
    b CRC "A. M. and A. Migliavacca" Center for Liver Disease, Division of Gastroenterology and Hepatology , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milan , Italy .

Abstract

Tenofovir disoproxil fumarate (TDF), an ester prodrug of tenofovir (TFV), is one of the recommended drugs for chronic hepatitis B (CHB) patients. However, reduced kidney function and loss of bone mineral density have been reported in some CHB patients treated with TDF. Consequent to these safety issues, tenofovir alafenamide (TAF) [Vemlidy®], a phosphonate prodrug of TFV, was developed for the treatment of CHB patients. Areas covered: The favourable pharmacological profile of TAF allows a marked reduction in dosage (25 mg/day) thus reducing systemic exposure to tenofovir and improving the bone and renal safety, keeping however the same virological efficacy, compared to TDF 300 mg/day. In two ongoing 96-week phase III trials in mainly treatment-naive HBeAg-positive or -negative patients, TAF showed similar viral suppression but was associated with significantly higher alanine aminotransferase normalization rates and more favourable renal and bone safety compared to TDF. In a 48-week TAF switch study enrolling patients treated with TDF for 96 weeks, glomerular, tubular and bone safety parameters rapidly improved while virological suppression was maintained. Expert commentary: Waiting long-term large scale clinical practice studies aimed to confirm these advantages, TAF represents an helpful treatment option for both naïve and TDF-exposed CHB patients.
KEYWORDS:

Antiviral therapy; HBV; Hepatitis B virus; Kidney; Safety; Tenofovir Alafenamide (TAF)

PMID:
    29338458
DOI:
    10.1080/14787210.2018.1428561

StephenW

Expert Rev Anti Infect Ther。 2018年1月17日。doi：10.1080 / 14787210.2018.1428561。 [电子版提前打印]
替诺福韦艾拉酚胺（TAF）治疗HBV，有哪些尚未解决的问题？
ViganòM1，Loglio A2，Grossi G2，Lampertico P2。
作者信息

1
    意大利米兰Universitàdegli Studi di Milano大学肝脏病学系，Ospedale San Giuseppe。
2
    b CRC“A. M.和A. Migliavacca”肝脏疾病中心，胃肠病学和肝病学部，Fondazione IRCCSCàGranda Ospedale Maggiore Policlinico，意大利米兰大学米兰大学。

抽象

替诺福韦酯替诺福韦酯（TDF）是替诺福韦（TFV）的酯类前药，是慢性乙型肝炎（CHB）患者的推荐药物之一。然而，在用TDF治疗的一些CHB患者中报道了肾功能降低和骨矿物质密度损失。随着这些安全性问题，替诺福韦艾拉酚胺（TAF）[TFV]的膦酸酯前药被开发用于治疗CHB患者。覆盖范围：与TDF 300毫克/天相比，TAF有利的药理学特征使得剂量显着减少（25毫克/天），因此降低了全身暴露于替诺福韦并改善骨和肾安全性，同时保持相同的病毒学功效。在主要接受治疗的HBeAg阳性或阴性患者中进行的两项正在进行的96周III期试验中，与TDF相比，TAF显示相似的病毒抑制作用，但与丙氨酸转氨酶标准化率显着更高以及更有利的肾脏和骨骼安全性相关。在接受TDF治疗96周患者的48周TAF转换研究中，肾小球，肾小管和骨骼安全性参数迅速改善，同时维持病毒学抑制。专家评论：等待长期的大规模临床实践研究旨在证实这些优势，TAF代表初治和TDF暴露CHB患者的有益治疗选择。
关键词：

抗病毒治疗; HBV;乙型肝炎病毒;肾;安全;替诺福韦丙氨苯丙胺（TAF）

结论：
    29338458
DOI：
    10.1080 / 14787210.2018.1428561

Hepbest

赞！
印度TAF是国内战友的福音

9病成医

小牡丹

TAF治疗乙肝，虽然是目前最好的药，但仍然是隔靴搔痒，离治愈还有十万八千里。所以，目前TAF的价格在每月100-200元之间是良心价。至于TDF价格应该在100以内，参照高血压药品价格。

9病成医

回复 小牡丹 的帖子

你给的价格，很诱人。

windu

初始治疗的人群选择ETV的应该更多吧，毕竟价格便宜

antiHBVren

回复 windu 的帖子

国内仿制的ETV效果不好，很多战友中招；