The efficacy of entecavir therapy in chronic hepatitis B patients with suboptimal response to adevofir

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04785.x/abstract;jse\

ssionid=ABAD484E394A2DC7392D4F7A1485C368.d01t03

The efficacy of entecavir therapy in chronic hepatitis B patients with

suboptimal response to adevofir

E. Sheen1, H. N. Trinh2,3, T. T. Nguyen4, S. T. Do5, P. Tran6, H. A. Nguyen2, K.

K. Nguyen2, R. T. 2,3, M. H. Nguyen7

Article first published online: 1 AUG 2011

DOI: 10.1111/j.1365-2036.2011.04785.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Online Version of Record published before inclusion in an issue)

Summary

Background  An increasing number of patients with chronic hepatitis B (CHB)

have experienced treatment failure to adefovir (ADV) and their management poses

a growing challenge. Very limited data are available on the efficacy of

entecavir (ETV) in patients previously treated with ADV.

Aim  To examine the effect of ETV monotherapy on HBV DNA and ALT levels in CHB

patients previously treated with ADV, but switched to ETV due to suboptimal

response.

Methods  Study candidates were enrolled from five community gastroenterology

clinics in the U.S. Each completed at least 12 months of ETV treatment after

being previously treated with ADV and experiencing suboptimal response. Primary

and secondary outcome measurements were complete viral suppression (CVS, HBV DNA

<100 IU/mL) and biochemical response (BR, ALT <40 U/L), respectively.

Results  A total of 60 patients were included in this analysis. Twelve were

lamivudine (LAM)-experienced and none were LAM-resistant. At time of switch to

ETV, no patients had experienced CVS. The CVS rate was 68% after 12 months of

ETV therapy. The BR rate was 67% at switch to ETV and 80% after 12 months. There

was no significant difference in response rates between LAM-experienced and

naïve patients. Among the eight patients with ADV resistance, each achieved CVS

after 12 months of ETV therapy and seven achieved BR.

Conclusions  In patients with suboptimal response to adefovir, complete viral

suppression and biochemical response can be achieved in the majority by 12

months after switching to entecavir, including patients with prior exposure to

lamivudine and those with adefovir resistance.