1. Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study
- Author
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Lung-Yi, Mak, Joseph, Hoang, Dae Won, Jun, Chien-Hung, Chen, Cheng-Yuan, Peng, Ming-Lun, Yeh, Sung Eun, Kim, Daniel Q, Huang, Jae Yoon, Jeong, Eileen, Yoon, Hyunwoo, Oh, Pei-Chien, Tsai, Chung-Feng, Huang, Sang Bong, Ahn, Huy, Trinh, Qing, Xie, Grace L H, Wong, Masaru, Enomoto, Jae-Jun, Shim, Dong-Hyun, Lee, Li, Liu, Ritsuzo, Kozuka, Yong Kyun, Cho, Soung Won, Jeong, Hyoung Su, Kim, Lindsey, Trinh, Allen, Dao, Rui, Huang, Rex Wan-Hin, Hui, Vivien, Tsui, Sabrina, Quek, Htet Htet Toe Wai, Khine, Eiichi, Ogawa, Chia Yen, Dai, Jee Fu, Huang, Ramsey, Cheung, Chao, Wu, Wan-Long, Chuang, Seng Gee, Lim, Ming-Lung, Yu, Man-Fung, Yuen, and Mindie H, Nguyen
- Subjects
Adult ,Male ,Guanine ,Hepatitis B, Chronic ,Treatment Outcome ,Humans ,Female ,Middle Aged ,Kidney ,Tenofovir ,Antiviral Agents ,Retrospective Studies - Abstract
We aimed to compare the longitudinal changes in estimated glomerular filtration rate (eGFR) in chronic hepatitis B (CHB) patients treated with entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF).This is a retrospective study of 6189 adult treatment-naïve CHB patients initiated therapy with TDF (n = 2482) or ETV (n = 3707) at 25 international centers using multivariable generalized linear modeling (GLM) to determine mean eGFR (mL/min/1.73 mIn the overall cohort (mean age 49.7 years, 66.2% male), the baseline eGFR was higher for TDF vs. ETV group (75.9 vs. 74.0, p = 0.009). PSM yielded 1871 pairs of ETV or TDF patients with baseline eGFR ≥ 60 and 520 pairs for the eGFR 60 group. GLM analysis of the overall (unmatched) cohort and PSM cohorts revealed lower adjusted mean eGFRs in TDF (vs. ETV) patients (all p 0.01) during 10 years of follow-up. Among PSM eGFR ≥ 60 patients, the 5-year cumulative incidences of renal impairment were 42.64% for ETV and 48.03% for TDF (p = 0.0023). In multivariable Cox regression, TDF vs. ETV (adjusted HR 1.26, 95% CI 1.11-1.43) was associated with higher risk of worsening renal function.Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.
- Published
- 2021