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Patients Previously Treated With Adefovir Can Achieve Complete Viral Suppression When Switched to Entecavir: Presented at AASLD
By Cheryl Lathrop
BOSTON -- November 2, 2009 -- Patients with hepatitis B virus (HBV) previously treated with adefovir (ADV) had complete viral suppression (CVS) and alanine aminotransferase (ALT) normalisation when switched to entecavir (ETV), researchers stated here at the Liver Meeting 2009, the 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).
Mindie H. Nguyen, MD, Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, reported the findings during a poster session here on October 31.
The researchers examined the CVS (HBV DNA <60-100 IU/mL) and ALT normalisation (<40 U/L) rates in patients who were switched from ADV to ETV. Patients were switched from ADV to ETV for 2 reasons: (1) a suboptimal response to ADV, or (2) to avoid the future development of resistance with long-term use of ADV.
Patients with chronic HBV were enrolled at 5 gastroenterology clinics (n = 105). Thirty-two patients were excluded for various reasons, leaving a study population of 73.
The 73 patients were divided into 2 groups. Group 1 included suboptimal responders to ADV treatment, defined as <2-log reduction in HBV DNA at 6 months or no CVS at 12 months (n = 67). Group 2 included responders to ADV treatment, defined as CVS with ADV but switched to ETV to avoid development of antiviral resistance (n = 6). In group 2, the patients who had CVS with ADV, all 6 were confirmed to have CVS and normal ALT.
No patients experienced a >2x upper limit of normal of ALT in the first 6 months after the switch. No patients experienced significant clinical adverse events after the switch. No ALT flares were observed during the switching process.
The majority (61%) of patients who had a prior partial response to ADV (group 1) achieved CVS by 6 months after the switch; this rate increased to 76% at 24 months. For the patients that had a CVS with ADV (group 2), all (100%) continued to have CVS and normal ALT after the switch.
[Presentation title: Complete Viral Suppression (CVS) and ALT Normalization on Entecavir (ETV) Therapy in Patients Who Were Previously Treated With Adefovir (ADV): A Multicenter Study. Abstract 494]
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