Switching to tenofovir disoproxil fumarate in entecavir‑treated chronic hepatitis B patients: A pilot randomized controlled study

Inoue,Jun; Akahane,Takehiro; Kobayashi,Tomoo; Obara,Noriyuki; Umetsu,Teruyuki; Kakazu,Eiji; Ninomiya,Masashi; Iwata,Tomoaki; Sano,Akitoshi; Tsuruoka,Mio; Sato,Kosuke; Masamune,Atsushi

doi:10.3892/br.2020.1396

Switching to tenofovir disoproxil fumarate in entecavir‑treated chronic hepatitis B patients: A pilot randomized controlled study

Authors:
- Jun Inoue
- Takehiro Akahane
- Tomoo Kobayashi
- Noriyuki Obara
- Teruyuki Umetsu
- Eiji Kakazu
- Masashi Ninomiya
- Tomoaki Iwata
- Akitoshi Sano
- Mio Tsuruoka
- Kosuke Sato
- Atsushi Masamune
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Affiliations: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980‑8574, Japan, Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi 986‑8522, Japan, Department of Hepatology, Tohoku Rosai Hospital, Sendai, Miyagi 981‑8563, Japan, Department of Gastroenterology, Japan Community Health care Organization Sendai Hospital, Sendai, Miyagi 981‑8501, Japan, Department of Internal Medicine, Kesen‑numa City Hospital, Kesennuma, Miyagi 988‑0181, Japan
Published online on: December 1, 2020 https://doi.org/10.3892/br.2020.1396
Article Number: 20
Copyright: © Inoue et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Although hepatitis B surface antigen (HBsAg) removal is considered the goal of chronic hepatitis B treatment, it can rarely be achieved with nucleos(t)ide analogues (NAs). It has been reported that tenofovir disoproxil fumarate (TDF) is superior in reducing HBsAg compared with entecavir (ETV) in treatment‑naïve patients; however, the effect of TDF in patients who have received NAs is still unclear. The aim of the present study was to evaluate the efficacy of switching from ETV to TDF in patients who were already receiving ETV. A pilot randomized controlled study for 2 years in patients who had been treated with ETV for >1 year and did not exhibit drug resistance was performed (Clinical trial registration: UMIN000021948, UMIN‑CTR, May 1, 2016). A total of 20 patients were enrolled and 19 patients were randomized into 2 groups, a TDF‑switching group (n=12) or an ETV‑continuing group (n=7). The mean change in HBsAg levels after 2 years was greater in the TDF group compared with the ETV group, but the difference was not significant (‑0.25 vs. ‑0.06 log IU/ml). In the TDF group, hepatitis B e antigen (HBeAg)‑positive patients at baseline showed significantly greater changes in HBsAg (‑0.63 vs. ‑0.03 log IU/ml; P=0.030). In contrast, no difference between HBeAg‑positive and HBeAg‑negative patients was observed in the ETV group. No significant differences of estimated glomerular filtration rate and inorganic phosphorus changes were observed among the TDF and ETV groups. In conclusion, a significant HBsAg decrease was not achieved after switching from ETV to TDF in the overall analysis, but HBeAg‑positive patients showed a larger HBsAg decrease after switching treatment.

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