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Treatment and renal outcomes up to 96 weeks after tenofovir alafenamide switch from tenofovir disoproxil fumarate in routine practice.

Treatment and renal outcomes up to 96 weeks after tenofovir alafenamide switch from tenofovir disoproxil fumarate in routine practice. Hepatology (Baltimore, Md.) Toyoda, H. n., Leong, J. n., Landis, C. n., Atsukawa, M. n., Watanabe, T. n., Huang, D. Q., Liu, J. n., Quek, S. X., Ishikawa, T. n., Arai, T. n., Yokohama, K. n., Chuma, M. n., Takaguchi, K. n., Uojima, H. n., Senoo, T. n., Dang, H. n., Maeda, M. n., Hoang, J. n., Le, R. H., Yasuda, S. n., Thin, K. N., Tran, S. n., Chien, N. n., Henry, L. n., Asai, A. n., Fukunishi, S. n., Cheung, R. n., Lim, S. G., Trinh, H. N., Nguyen, M. H. 2021

Abstract

Real-world data for treatment effectiveness and renal outcomes in chronic hepatitis B (CHB) patients who were switched to the new and safer pro-drug, tenofovir alafenamide (TAF) from tenofovir disoproxil fumarate (TDF) are limited. Therefore, we aimed to evaluate treatment and renal outcomes of this population.We analyzed 834 CHB patients previously treated with TDF for =12 months who were switched to TAF in routine practice at 13 U.S. and Asia centers for changes in viral (HBV DNA <20 IU/mL), biochemical (ALT <35/25 U/L for male/ female) and complete (viral+biochemical) response; as well as estimated glomerular filtration rate (eGFR, mL/min/1.73 m2 ) up to 96-weeks after switch. Viral suppression (P<0.001) and ALT normalization (P=0.003) rates increased significantly after switch, as well as trend for increasing complete response (Ptrend =0.004) while eGFR trend (Ptrend >0.44) or mean eGFR (P>0.83, adjusted for age, sex, baseline eGFR, and diabetes, hypertension or cirrhosis by generalized linear modeling) remained stable. However, among those with baseline eGFR <90 (CKD stage =2), mean eGFR decreased significantly while on TDF (P=0.029) but not after TAF switch (P=0.90). By week 96, 21% (55/267) of patients with CKD stage 2 at switch improved to stage 1, 35% (30/85) of CKD stage 3-5 patients improved to stage 2 and 1.2% (1/85) to stage 1.Overall, we observed continued improvement in virologic response, ALT normalization, and no significant changes in eGFR following switch to TAF from TDF.

View details for DOI 10.1002/hep.31793

View details for PubMedID 33706421