Comparison of the Effects of Telbivudine and Entecavir Treatment on Estimated Glomerular Filtration Rate in Patients with Chronic Hepatitis B

Gut Liver. 2015 Nov 23;9(6):776-83. doi: 10.5009/gnl14297.

Abstract

Background/aims: The aim of this study was to evaluate the estimated glomerular filtration rate (eGFR) during telbivudine (LdT) versus entecavir (ETV) treatment in chronic hepatitis B (CHB) patients with underlying comorbidities such as diabetes mellitus (DM), hypertension, and cirrhosis.

Methods: From 2010 to 2012, 116 CHB patients treated with LdT and 578 treated with ETV were compared in this real-practice cohort. The mean changes in eGFR (Modification of Diet in Renal Disease [MDRD] formula) from baseline to months 6, 12, and 18 were analyzed using a linear mixed model.

Results: In LdT-treated patients, the mean eGFR increased by 7.6% at month 18 compared with the eGFR at baseline (MDRD formula in mL/min/1.73 m(2)). However, in ETV-treated patients, the mean eGFR decreased by 4.1% at month 18 compared with the eGFR at baseline. In the LdT-treated patients with DM, hypertension, cirrhosis or low eGFR <90 mL/min/1.73 m(2), the mean eGFR showed a steady improvement, whereas the mean eGFR was reduced in the same subgroups of ETV-treated patients.

Conclusions: The eGFR gradually increased over time during LdT treatment, especially in patients with mild abnormal eGFR at baseline, and in those with DM, hypertension, and cirrhosis, whereas a reduction in eGFR was seen with ETV treatment.

Keywords: Entecavir; Estimated glomerular filtration rate; Telbivudine.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage*
  • Diabetes Complications
  • Diabetes Mellitus
  • Drug Administration Schedule
  • Female
  • Fibrosis / complications
  • Glomerular Filtration Rate / drug effects*
  • Guanine / administration & dosage
  • Guanine / analogs & derivatives*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / physiopathology
  • Humans
  • Hypertension / complications
  • Linear Models
  • Male
  • Middle Aged
  • Telbivudine
  • Thymidine / administration & dosage
  • Thymidine / analogs & derivatives*
  • Time Factors
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Telbivudine
  • entecavir
  • Guanine
  • Thymidine