Cargando…

The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy

BACKGROUND/AIMS: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combi...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Jeong Han, Ahn, Sung Hyun, Ko, Soon Young, Choe, Won Hyeok, Kim, Kyun-Hwan, Kwon, So Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946405/
https://www.ncbi.nlm.nih.gov/pubmed/27304549
http://dx.doi.org/10.3350/cmh.2015.0053
_version_ 1782443023116795904
author Kim, Jeong Han
Ahn, Sung Hyun
Ko, Soon Young
Choe, Won Hyeok
Kim, Kyun-Hwan
Kwon, So Young
author_facet Kim, Jeong Han
Ahn, Sung Hyun
Ko, Soon Young
Choe, Won Hyeok
Kim, Kyun-Hwan
Kwon, So Young
author_sort Kim, Jeong Han
collection PubMed
description BACKGROUND/AIMS: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combination therapy and investigated the clinical and clonal results of TDF-based rescue therapy in CHB patients refractory to this combination. METHODS: We retrospectively reviewed the medical records of CHB patients treated for up to 3 years with ETV-ADV combination therapy as a rescue therapy for drug resistance. In cases refractory to this combination, clinical and clonal analyses were performed for TDF-based rescue therapy. RESULTS: The analysis was performed on 48 patients. Twelve patients achieved a virological response (VR) within 3 years. A VR was subsequently achieved in nine of the ten patients without a VR who switched to TDF monotherapy. A VR was also achieved in six of the seven patients who switched to lamivudine-TDF combination therapy, and in two of the two patients who switched to ETV-TDF combination therapy. In an in vitro susceptibility test, viral replication was detected with TDF monotherapy but not with ETV-TDF combination therapy. CONCLUSIONS: The efficacy of ETV-ADV combination therapy was insufficient in CHB patients who were refractory to rescue therapy. A more potent regimen such as ETV-TDF combination therapy may be considered in such refractory cases.
format Online
Article
Text
id pubmed-4946405
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher The Korean Association for the Study of the Liver
record_format MEDLINE/PubMed
spelling pubmed-49464052016-07-18 The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy Kim, Jeong Han Ahn, Sung Hyun Ko, Soon Young Choe, Won Hyeok Kim, Kyun-Hwan Kwon, So Young Clin Mol Hepatol Original Article BACKGROUND/AIMS: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combination therapy and investigated the clinical and clonal results of TDF-based rescue therapy in CHB patients refractory to this combination. METHODS: We retrospectively reviewed the medical records of CHB patients treated for up to 3 years with ETV-ADV combination therapy as a rescue therapy for drug resistance. In cases refractory to this combination, clinical and clonal analyses were performed for TDF-based rescue therapy. RESULTS: The analysis was performed on 48 patients. Twelve patients achieved a virological response (VR) within 3 years. A VR was subsequently achieved in nine of the ten patients without a VR who switched to TDF monotherapy. A VR was also achieved in six of the seven patients who switched to lamivudine-TDF combination therapy, and in two of the two patients who switched to ETV-TDF combination therapy. In an in vitro susceptibility test, viral replication was detected with TDF monotherapy but not with ETV-TDF combination therapy. CONCLUSIONS: The efficacy of ETV-ADV combination therapy was insufficient in CHB patients who were refractory to rescue therapy. A more potent regimen such as ETV-TDF combination therapy may be considered in such refractory cases. The Korean Association for the Study of the Liver 2016-06 2016-06-15 /pmc/articles/PMC4946405/ /pubmed/27304549 http://dx.doi.org/10.3350/cmh.2015.0053 Text en Copyright © 2016 by The Korean Association for the Study of the Liver This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jeong Han
Ahn, Sung Hyun
Ko, Soon Young
Choe, Won Hyeok
Kim, Kyun-Hwan
Kwon, So Young
The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title_full The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title_fullStr The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title_full_unstemmed The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title_short The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
title_sort efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946405/
https://www.ncbi.nlm.nih.gov/pubmed/27304549
http://dx.doi.org/10.3350/cmh.2015.0053
work_keys_str_mv AT kimjeonghan theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT ahnsunghyun theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kosoonyoung theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT choewonhyeok theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kimkyunhwan theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kwonsoyoung theefficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kimjeonghan efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT ahnsunghyun efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kosoonyoung efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT choewonhyeok efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kimkyunhwan efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy
AT kwonsoyoung efficacyoftenofovirbasedtherapyinpatientsshowingsuboptimalresponsetoentecaviradefovircombinationtherapy