Published in:
Open Access
01-10-2016 | Original Article
Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Chronic Hepatitis B: A 3-Year, Prospective, Real-World Study in France
Authors:
Patrick Marcellin, Fabien Zoulim, Christophe Hézode, Xavier Causse, Bruno Roche, Régine Truchi, Arnaud Pauwels, Denis Ouzan, Jérôme Dumortier, Georges-Philippe Pageaux, Marc Bourlière, Ghassan Riachi, Jean-Pierre Zarski, Jean-François Cadranel, Valérie Tilliet, Christiane Stern, Pascal Pétour, Olivier Libert, Silla M. Consoli, Dominique Larrey
Published in:
Digestive Diseases and Sciences
|
Issue 10/2016
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Abstract
Background and Aims
Tenofovir disoproxil fumarate (TDF) demonstrated potent and sustainable antiviral efficacy and a good safety profile in patients with chronic hepatitis B (CHB) in controlled clinical trials. Real-world data are important to confirm effectiveness and safety data in patient populations encountered in routine clinical practice.
Methods
This non-interventional, prospective, 36-month study included treatment-naïve and treatment-experienced patients with CHB initiating their first TDF regimen (monotherapy or combination therapy) in routine clinical practice in France. Clinical, virologic, biochemical, compliance, and safety data were collected.
Results
Data from 440 consecutive patients from 58 centers were analyzed. The majority of the cohort was male (71 %), hepatitis B “e” antigen-negative (HBeAg–) (74 %), and treatment-experienced (56 %); 11 % were aged ≥65 years; and comorbidities were reported in 39 %. After 12 months, 92 % of the overall cohort achieved virologic response (HBV DNA <69 IU/mL) which was maintained to 36 months (96 %); virologic response was achieved by >90 % of patients irrespective of HBeAg status, age, or prior treatment history. At 36 months, 77 % of patients had normal alanine aminotransferase levels. Fourteen patients lost hepatis B surface (HBs) antigen, and seven seroconverted to anti-HBs. TDF was well tolerated over the 36-month study, including in 14 women who became pregnant during the study. Median estimated glomerular filtration rate did not change markedly from baseline irrespective of prior treatment history.
Conclusions
TDF demonstrated potent virologic and biochemical responses across a broad range of patients reflective of routine clinical practice. The safety profile was consistent with results from pivotal trials.