Non-Inferior Efficacy of Tenofovir Disoproxil to Tenofovir Disoproxil Fumarate in Virologically Suppressed Chronic Hepatitis B Patients

Hyung Joon Yim, Ji Hoon Kim, Yong Kyun Cho, Young Oh Kweon, Hyun Chin Cho, Jae Seok Hwang, Changhyeong Lee, Moon Soo Koh, Yang Hyun Baek, Young Min Park, Jeong Hoon Lee, Seung Up Kim, Min Kyu Kang, Neung Hwa Park, June Sung Lee, Young Eun Chon, Gab Jin Cheon, Hee Bok Chae, Joo Hyun Sohn, Young Suk Lim

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Tenofovir disoproxil (TD), modified from tenofovir disoproxil fumarate (TDF), was developed as a salt-free formula-tion, removing fumarate to improve the ease of oral intake by reducing the tablet’s size. We evaluated the maintenance of antiviral effects and overall safety profile of TD 245 mg after switching from TDF 300 mg in patients with chronic hepatitis B (CHB). Patients and Methods: CHB patients with HBV-DNA <69 IU/mL after ≥24 weeks of TDF therapy were enrolled. The primary efficacy endpoint was the HBV-DNA suppression rate (HBV-DNA <69 IU/mL) at week 48; We evaluated the non-inferiority (10% margin) of TD to TDF in terms of efficacy. Safety was assessed based on adverse events (AEs), laboratory tests, bone mineral density, and renal function abnormalities. Results: Overall, 189 subjects were randomized in a 2:1 ratio, and 117 and 66 subjects in the TD and TDF groups, respectively, completed the study. In the per-protocol set, the HBV-DNA suppression rate at week 48 was 99.1% and 100% in the TD and TDF groups, respectively. The lower limit of the 97.5% one-sided confidence interval for the intergroup difference in HBV-DNA suppression rate was −2.8%, which was greater than the prespecified margin of non-inferiority. The changes in creatinine clearance from baseline to week 48 was significantly less in the TD group and in the TDF group; −0.8 ± 9.8 versus −2.4 ± 12.8 mL/min, respectively (P=0.017). Conclusion: TD was non-inferior to TDF for maintaining viral suppression in CHB patients, showing the less decline of renal function.

Original languageEnglish
Pages (from-to)3263-3274
Number of pages12
JournalDrug Design, Development and Therapy
Volume16
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022 Yim et al.

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmaceutical Science
  • Drug Discovery

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