Tenofovir amibufenamide vs tenofovir alafenamide for treating chronic hepatitis B: A real-world study

World J Gastroenterol. 2023 Nov 28;29(44):5907-5918. doi: 10.3748/wjg.v29.i44.5907.

Abstract

Background: The efficacy and safety profile of tenofovir amibufenamide (TMF) in chronic hepatitis B (CHB) patients is not well-established.

Aim: To compare the efficacy and safety of TMF and tenofovir alafenamide (TAF) over a 48-wk period in patients with CHB.

Methods: A total of 215 subjects meeting the inclusion criteria were enrolled and divided into two groups: TMF group (n = 106) and the TAF group (n = 109). The study included a comparison of virological response (VR): Undetectable hepatitis B virus DNA levels, alanine transaminase (ALT) normalization rates, renal function parameters, and blood lipid profiles.

Results: At 24 and 48 wk, VR rates for the TMF group were 53.57% and 78.57%, respectively, compared with 48.31% and 78.65% for the TAF group (P > 0.05). The VR rates were also similar in both groups among patients with low-level viremia, both hepatitis B e antigen (HBeAg)-positive and HBeAg-negative subgroups. The TMF cohort showed ALT normalization and renal safety profiles similar to the TAF group. There was a notable increase in total cholesterol levels in the TAF group (P = 0.045), which was not observed in the TMF group (P > 0.05). In patients with liver cirrhosis, both groups exhibited comparable VR and ALT normalization rates and renal safety profiles. However, the fibrosis 4 score at 48 wk showed a significant reduction in the TAF group as compared to the TMF group within the liver cirrhosis subgroup.

Conclusion: Our study found TMF is as effective as TAF in treating CHB and has a comparable safety profile. However, TAF may be associated with worsening lipid profiles.

Keywords: Alanine transaminase normalization; Blood lipid; Chronic hepatitis B; Renal safety; Tenofovir; Virological response.

MeSH terms

  • Adenine / adverse effects
  • Adenine / therapeutic use
  • Alanine Transaminase
  • Antiviral Agents* / adverse effects
  • Hepatitis B e Antigens
  • Hepatitis B, Chronic* / diagnosis
  • Hepatitis B, Chronic* / drug therapy
  • Humans
  • Lipids
  • Liver Cirrhosis / drug therapy
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Tenofovir* / adverse effects
  • Tenofovir* / therapeutic use

Substances

  • Adenine
  • Alanine Transaminase
  • Antiviral Agents
  • Hepatitis B e Antigens
  • Lipids
  • Reverse Transcriptase Inhibitors
  • Tenofovir