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DOI: 10.1055/s-0031-1295909
Telbivudine treatment improves renal function of Chronic Hepatitis B (CHB) patients
Complications of CHB including cirrhosis result in nearly 1 million deaths annually. Renal dysfunction is common in decompensated CHB cirrhosis and is associated with high mortality. Nucleot(s)ide treatment improves liver function and survival. Renal dysfunction can reduce clearance of nucleot(s)ides increasing drug-associated toxicities resulting with high mortality. Recently, study on decompensated CHB patients showed significantly improvement of GFR for those receiving telbivudine in comparison to patients under lamivudine. We assessed GFR in compensated CHB patients included in several pivotal telbivudine (LDT) trials. GFR was performed at baseline (BL), Week 52 (W52), W104 and W208 by MDRD (Modification of Diet in Renal Disease): LDT vs. lamivudine (LAM) (n=1370); LDT for 4-years (n=1869); 2 years LDT vs. LAM in decompensated patients (n=232); LDT roadmap study with tenofovir (TDF) add-on (n=105).
avs baseline. P< 0.001. cLDT vs. LAM. P<0.0001. cvs baseline. P=0.005. dLDT vs. LAM. P=0.0231. evs baseline. P<0.0001 fvs baseline. P < 0.01 |
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Treatment duration |
Study |
Patients # |
BLGFR |
GFR Change |
% of patients with baseline |
|
(MDRD) |
from B L |
GFR 60–90 shifted to >90 |
||||
1 year |
ACN03 |
LDT |
983 |
98.1 |
3.8a |
55.5% (n=211) |
GLOBE (RCT, double blind) |
LDT |
680 |
98.3 |
5.1b |
61.7% (n=256) |
|
LAM |
680 |
99.8 |
-1.0b |
- |
||
A2410 |
LDT |
55 |
93 |
6.9C |
50.0% (n=22) |
|
LDT+TDF |
45 |
93 |
7.4C |
43.84% (n=16) |
||
real life |
LDT+TDF |
19 |
86.7 |
18.9f |
- |
|
2 year |
GLOBE (RCT, double blind) |
LDT |
680 |
98.3 |
6.7b |
72.3% (n=256) |
LAM |
687 |
99.8 |
-1.8b |
- |
||
A2301 decom (RCT, double blind) |
LDT |
114 |
105 |
2.0cl |
40.7% (n=27) |
|
LAM |
114 |
101 |
-4.6:i |
31.4% (n=35) |
||
real life |
LDT+TDF |
19 |
86.7 |
18.6f |
- |
|
3 year |
A2303 |
LDT |
587 |
95 |
21 |
81% (n=268) |
4 year |
A2303 |
LDT |
511 |
95 |
14.9 |
74% (n=223) |
6 year |
ACN04E1 |
LDT |
57 |
87.5 |
44.1e |
94.9% (n=39) |
Telbivudine or telbivudine with add-on tenofovir treatment improves GFR in patients with compensated and decompensated CHB. The mechanism of this improvement is not clearly understood.
GFR - Hepatitis B - Renal Function - Telbivudine