Efficacy of switching to telbivudine in chronic hepatitis B patients treated previously with lamivudine

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Efficacy of switching to telbivudine in chronic hepatitis B patients treated

previously with lamivudine

Liver International, 04/08/2011 Clinical Article

Safadi R et al. - Early (≤24 weeks) switch to telbivudine improves virological

outcomes in chronic hepatitis B(CHB) patients with persistent viral replication

under lamivudine treatment.

Methods • HBeAg-positive and HBeAg-negative adult patients (N=246) with

persistent viraemia under lamivudine treatment for 12-52 weeks were randomized

(1:1) to continue lamivudine 100 mg/day or switch to telbivudine 600 mg/day for

1 year.

• Primary endpoint was the reduction in serum hepatitis B virus(HBV) DNA

levels from baseline at Week 24.

Results • Mean reduction in serum HBV DNA levels from baseline with

telbivudine was significantly higher than lamivudine at Week 24 and maintained

through 1 year.

• Rate of treatment failure was significantly lower for patients who switched

to telbivudine (5%) compared with those who continued lamivudine (20%) after 52

weeks of treatment.

• In telbivudine group, treatment failure occurred in only five patients with

>24 weeks of prior lamivudine treatment, all associated with pre-existent

lamivudine-resistant mutations.

• Genotypic resistance rates were higher in patients continuing lamivudine

compared with those who switched to telbivudine with <24 weeks of lamivudine

exposure.

• Both treatments were well tolerated with similar safety profiles.