Add-n Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for Lamivudine-Resistant Chronic Hepatitis B.

[Guest guest]

Dig Dis Sci. 2011 Jan 21. [Epub ahead of print]

Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for

Lamivudine-Resistant Chronic Hepatitis B.

Chung GE, Kim W, Lee KL, Hwang SY, Lee JH, Kim HY, Jung YJ, Kim D, Jeong JB, Kim

BG, Kim YJ, Yoon JH, Lee HS.

Department of Internal Medicine, Gangnam Healthcare Center, Seoul National

University Hospital, Seoul, Republic of Korea.

Abstract

BACKGROUND/AIMS: Lamivudine (LAM) has been extensively used to treat hepatitis

B, but high incidence of drug resistance has required rescue studies. We

validated the optimum treatment strategy for LAM-resistant patients by means of

a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV).

METHODS: We assessed the virologic response in consecutive LAM-resistant

patients who received add-on ADV or a switch to ETV.

RESULTS: The mean reduction of serum hepatitis B virus (HBV) DNA levels was

significantly less in the ETV group than in the add-on ADV group (-3.45 vs.

-4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week

48). Achievement of undetectable HBV DNA was significantly lower in the ETV

group than in the add-on ADV group (P = 0.043). Multivariate analysis showed

that add-on ADV, baseline HBV DNA levels, and initial virologic response were

significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008,

0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for

12 patients, in the ETV group only.

CONCLUSIONS: Add-on ADV was more effective and durable than ETV as rescue

therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant

patients who need long-term antiviral treatment.

PMID: 21253834 [PubMed - as supplied by publisher]

[Guest guest]

Dig Dis Sci. 2011 Jan 21. [Epub ahead of print]

Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for

Lamivudine-Resistant Chronic Hepatitis B.

Chung GE, Kim W, Lee KL, Hwang SY, Lee JH, Kim HY, Jung YJ, Kim D, Jeong JB, Kim

BG, Kim YJ, Yoon JH, Lee HS.

Department of Internal Medicine, Gangnam Healthcare Center, Seoul National

University Hospital, Seoul, Republic of Korea.

Abstract

BACKGROUND/AIMS: Lamivudine (LAM) has been extensively used to treat hepatitis

B, but high incidence of drug resistance has required rescue studies. We

validated the optimum treatment strategy for LAM-resistant patients by means of

a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV).

METHODS: We assessed the virologic response in consecutive LAM-resistant

patients who received add-on ADV or a switch to ETV.

RESULTS: The mean reduction of serum hepatitis B virus (HBV) DNA levels was

significantly less in the ETV group than in the add-on ADV group (-3.45 vs.

-4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week

48). Achievement of undetectable HBV DNA was significantly lower in the ETV

group than in the add-on ADV group (P = 0.043). Multivariate analysis showed

that add-on ADV, baseline HBV DNA levels, and initial virologic response were

significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008,

0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for

12 patients, in the ETV group only.

CONCLUSIONS: Add-on ADV was more effective and durable than ETV as rescue

therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant

patients who need long-term antiviral treatment.

PMID: 21253834 [PubMed - as supplied by publisher]

[Guest guest]

Dig Dis Sci. 2011 Jan 21. [Epub ahead of print]

Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for

Lamivudine-Resistant Chronic Hepatitis B.

Chung GE, Kim W, Lee KL, Hwang SY, Lee JH, Kim HY, Jung YJ, Kim D, Jeong JB, Kim

BG, Kim YJ, Yoon JH, Lee HS.

Department of Internal Medicine, Gangnam Healthcare Center, Seoul National

University Hospital, Seoul, Republic of Korea.

Abstract

BACKGROUND/AIMS: Lamivudine (LAM) has been extensively used to treat hepatitis

B, but high incidence of drug resistance has required rescue studies. We

validated the optimum treatment strategy for LAM-resistant patients by means of

a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV).

METHODS: We assessed the virologic response in consecutive LAM-resistant

patients who received add-on ADV or a switch to ETV.

RESULTS: The mean reduction of serum hepatitis B virus (HBV) DNA levels was

significantly less in the ETV group than in the add-on ADV group (-3.45 vs.

-4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week

48). Achievement of undetectable HBV DNA was significantly lower in the ETV

group than in the add-on ADV group (P = 0.043). Multivariate analysis showed

that add-on ADV, baseline HBV DNA levels, and initial virologic response were

significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008,

0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for

12 patients, in the ETV group only.

CONCLUSIONS: Add-on ADV was more effective and durable than ETV as rescue

therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant

patients who need long-term antiviral treatment.

PMID: 21253834 [PubMed - as supplied by publisher]

[Guest guest]

Dig Dis Sci. 2011 Jan 21. [Epub ahead of print]

Add-On Adefovir Is Superior to a Switch to Entecavir as Rescue Therapy for

Lamivudine-Resistant Chronic Hepatitis B.

Chung GE, Kim W, Lee KL, Hwang SY, Lee JH, Kim HY, Jung YJ, Kim D, Jeong JB, Kim

BG, Kim YJ, Yoon JH, Lee HS.

Department of Internal Medicine, Gangnam Healthcare Center, Seoul National

University Hospital, Seoul, Republic of Korea.

Abstract

BACKGROUND/AIMS: Lamivudine (LAM) has been extensively used to treat hepatitis

B, but high incidence of drug resistance has required rescue studies. We

validated the optimum treatment strategy for LAM-resistant patients by means of

a comparative study of add-on adefovir (ADV) and a switch to entecavir (ETV).

METHODS: We assessed the virologic response in consecutive LAM-resistant

patients who received add-on ADV or a switch to ETV.

RESULTS: The mean reduction of serum hepatitis B virus (HBV) DNA levels was

significantly less in the ETV group than in the add-on ADV group (-3.45 vs.

-4.17; P = 0.047 at week 24 and -3.81 vs. -4.68 log(10) IU/mL; P = 0.044 at week

48). Achievement of undetectable HBV DNA was significantly lower in the ETV

group than in the add-on ADV group (P = 0.043). Multivariate analysis showed

that add-on ADV, baseline HBV DNA levels, and initial virologic response were

significant predictors of HBV DNA negativity (adjusted OR, 2.582; P = 0.008,

0.304; P = 0.001, and 5.928; P = 0.001). Virologic breakthrough was observed for

12 patients, in the ETV group only.

CONCLUSIONS: Add-on ADV was more effective and durable than ETV as rescue

therapy. Therefore, add-on ADV might be the preferred strategy for LAM-resistant

patients who need long-term antiviral treatment.

PMID: 21253834 [PubMed - as supplied by publisher]