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2016 ; 16
(1
): e32528
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Estimated Glomerular Filtration Rate Increases in Chronic Hepatitis B Patients
Treated With Telbivudine Monotherapy and Combination Treatment
#MMPMID27110258
Jiang L
; Hu S
; He M
; Tian D
Hepat Mon
2016[Jan]; 16
(1
): e32528
PMID27110258
show ga
BACKGROUND: Several studies have reported a renoprotective effect of telbivudine
during the treatment of patients for chronic hepatitis B (CHB). OBJECTIVES: This
longitudinal retrospective study aimed to examine the effects of telbivudine
monotherapy and combination therapy (adefovir plus telbivudine) on renal
function. PATIENTS AND METHODS: This study included 336 Chinese CHB patients, who
were selected from outpatients in Tongji Hospital. 44, 122, 66, 58, and 46 of
these patients had been orally taking adefovir, telbivudine, entecavir, adefovir
plus telbivudine, and adefovir plus lamivudine, respectively, for at least 24
months. RESULTS: The estimated glomerular filtration rate (eGFR) in the
telbivudine and adefovir plus telbivudine groups increased by 5.14 mL/min (P <
0.001) and 6.19 mL/min (P = 0.005), respectively. The patients taking the five
drug regimens were further grouped into the following three subpopulations: those
with compensated hepatic cirrhosis, those aged 50 or more years, and those with
baseline eGFR values of 50 - 90 mL/min. The three subgroups that received
telbivudine monotherapy exhibited eGFR increases of 6.38, 6.74, and 10.82 mL/min,
respectively. The three subgroups that received combination therapy of adefovir
plus telbivudine exhibited eGFR increases of 18.31, 14.73, and 16.59 mL/min,
respectively (P < 0.05). The predictive factors for the change in eGFR levels
over time were analyzed by means of two linear mixed effects models for the three
monotherapy regimens and two combination regimens. Age, gender, and medication
are predictive factors of eGFR changes. In addition, abnormal creatinine kinase
(CK) levels in the telbivudine group were not correlated with eGFR changes (P =
0.992). CONCLUSIONS: These findings indicate that telbivudine, used in both
monotherapy and combination therapy, improves the renal function of patients with
CHB. The improvements are particularly significant in patients at high renal
risk.