TY - JOUR
T1 - Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide
AU - Roade, Luisa
AU - Loglio, Alessandro
AU - Borghi, Marta
AU - Riveiro-Barciela, Mar
AU - Soffredini, Roberta
AU - Facchetti, Floriana
AU - di Paolo, Dhanai
AU - Tabernero, David
AU - Lunghi, Giovanna
AU - Esteban, Rafael
AU - Buti, Maria
AU - Lampertico, Pietro
PY - 2020
Y1 - 2020
N2 - Background: To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir. Aims: To estimate the number of patients who would benefit from a treatment switch in a real-life setting. Methods: Consecutive hepatitis B patients receiving tenofovir-disoproxil before 31 December 2017 were enrolled in a cross-sectional study in two European hospitals. Clinical and virological data were recorded; renal function was assessed by estimated glomerular filtrate rate, serum phosphate and creatinine, proteinuria, and albuminuria; bone involvement by spine and femur DEXA scan. Results: In total, 565 patients included: 62 (18–91) years, 75% males, 92% Caucasian, 92% HBeAg-negative, 40% cirrhotic. Fifty-five percent of patients fulfilled age criterion (>60 years). Older patients had higher rates of cirrhosis (51% vs 26%, p<0.001), cardiovascular disease, and renal impairment. Thirty-six percent of patients met renal criteria, more commonly NA-experienced individuals (35% vs 21%, p=0.001); 17% had bone disease. Overall, 66% of patients had at least one criterion (71% if NA-experienced), 8% all three criteria, 28% age and renal criteria. Conclusions: Approximately two-thirds of patients receiving long-term tenofovir-disoproxil are candidates for an entecavir or tenofovir-alafenamide switch according to EASL recommendations
AB - Background: To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir. Aims: To estimate the number of patients who would benefit from a treatment switch in a real-life setting. Methods: Consecutive hepatitis B patients receiving tenofovir-disoproxil before 31 December 2017 were enrolled in a cross-sectional study in two European hospitals. Clinical and virological data were recorded; renal function was assessed by estimated glomerular filtrate rate, serum phosphate and creatinine, proteinuria, and albuminuria; bone involvement by spine and femur DEXA scan. Results: In total, 565 patients included: 62 (18–91) years, 75% males, 92% Caucasian, 92% HBeAg-negative, 40% cirrhotic. Fifty-five percent of patients fulfilled age criterion (>60 years). Older patients had higher rates of cirrhosis (51% vs 26%, p<0.001), cardiovascular disease, and renal impairment. Thirty-six percent of patients met renal criteria, more commonly NA-experienced individuals (35% vs 21%, p=0.001); 17% had bone disease. Overall, 66% of patients had at least one criterion (71% if NA-experienced), 8% all three criteria, 28% age and renal criteria. Conclusions: Approximately two-thirds of patients receiving long-term tenofovir-disoproxil are candidates for an entecavir or tenofovir-alafenamide switch according to EASL recommendations
KW - Bone safety
KW - ETV
KW - HBV
KW - Nucleos(t)ide analogues
KW - Renal safety
KW - TAF
KW - TDF
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U2 - 10.1016/j.dld.2020.06.037
DO - 10.1016/j.dld.2020.06.037
M3 - Article
AN - SCOPUS:85088117780
VL - 52
SP - 1164
EP - 1169
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 10
ER -