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Non-Inferior Efficacy of Tenofovir Disoproxil to Tenofovir Disoproxil Fumarate in Virologically Suppressed Chronic Hepatitis B Patients

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Author(s)
Hyung Joon YimJi Hoon KimYong Kyun ChoYoung Oh KweonHyun Chin ChoJae Seok HwangChanghyeong LeeMoon Soo KohYang-Hyun BaekYoung-Min ParkJeong-Hoon LeeSeung Up KimMin-Kyu KangNeung Hwa ParkJune Sung LeeYoung Eun ChonGab Jin CheonHee Bok ChaeJoo Hyun SohnYoung-Suk Lim
Keimyung Author(s)
Hwang, Jae Seok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Drug Des Devel Ther
Issued Date
2022
Volume
16
Keyword
antiviral agentsbone densityviral DNAviral suppression
Abstract
Purpose:
Tenofovir disoproxil (TD), modified from tenofovir disoproxil fumarate (TDF), was developed as a salt-free formulation, removing fumarate to improve the ease of oral intake by reducing the tablet's size. We evaluated the maintenance of antiviral effects and overall safety profile of TD 245 mg after switching from TDF 300 mg in patients with chronic hepatitis B (CHB).

Patients and methods:
CHB patients with HBV-DNA <69 IU/mL after ≥24 weeks of TDF therapy were enrolled. The primary efficacy endpoint was the HBV-DNA suppression rate (HBV-DNA <69 IU/mL) at week 48; We evaluated the non-inferiority (10% margin) of TD to TDF in terms of efficacy. Safety was assessed based on adverse events (AEs), laboratory tests, bone mineral density, and renal function abnormalities.

Results:
Overall, 189 subjects were randomized in a 2:1 ratio, and 117 and 66 subjects in the TD and TDF groups, respectively, completed the study. In the per-protocol set, the HBV-DNA suppression rate at week 48 was 99.1% and 100% in the TD and TDF groups, respectively. The lower limit of the 97.5% one-sided confidence interval for the intergroup difference in HBV-DNA suppression rate was -2.8%, which was greater than the prespecified margin of non-inferiority. The changes in creatinine clearance from baseline to week 48 was significantly less in the TD group and in the TDF group; -0.8 ± 9.8 versus -2.4 ± 12.8 mL/min, respectively (P=0.017).

Conclusion:
TD was non-inferior to TDF for maintaining viral suppression in CHB patients, showing the less decline of renal function.
Keimyung Author(s)(Kor)
황재석
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1177-8881
Source
https://www.dovepress.com/non-inferior-efficacy-of-tenofovir-disoproxil-to-tenofovir-disoproxil--peer-reviewed-fulltext-article-DDDT
DOI
10.2147/DDDT.S376821
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44527
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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