ネイティブによる読み上げ音声はこちらをクリックしてください。 TDF beneﬁcial Long-term TDF in chronic therapyHBV oﬀers patients sustained with suboptimal responsewithout to lamivudine plus adefovir HBV suppression resistance By Shreeya Nanda, Senior medwireNews Reporter 2015; 21: 2746‒2753 medwireNews: Patients with lamivudine-resistant chronic hepatitis B virus (HBV) infection who respond poorly to lamivudine plus adefovir dipivoxil (ADV) can benefit from switching to tenofovir disoproxil fumarate (TDF) monotherapy, research findings indicate. TDF treatment “significantly suppressed” HBV replication in this patient population, say Hong-Ying Pan (Zhejiang Provincial People’s Hospital, Hangzhou, China) and co-authors in the World Journal of Gastroenterology. Of the 28 patients who received TDF, 17.86% achieved a virological response, defined as serum HBV DNA below 103 copies/mL, at week 4, with the proportion of patients achieving a response increasing to 75%, 82.14%, 89.29% and 96.43% at weeks 12, 24, 36 and 48, respectively. This compared with a virological response rate of 6.45%, 16.13%, 22.58%, 25.81% and 29.03% at the equivalent timepoints in the 31 patients who remained on lamivudine plus ADV. The difference between the groups was statistically significant at all timepoints except at week 4. At week 12, normalisation of alanine aminotransferase (ALT) levels occurred in 75% of TDF-treated patients and in 17.86% of participants in the lamivudine plus ADV group, a significant difference. But the difference between the groups was no longer significant at weeks 24 (78.57 vs 54.84%) and 48 (89.26 vs 67.74%). Hepatitis B e antigen (HBeAg) loss was achieved by one of the 25 patients in the TDF group and none of the 27 in the lamivudine plus ADV group who had been HBeAg-positive at baseline, a nonsignificant difference, leading the researchers to comment that “a greater HBV DNA reduction may not necessarily accelerate HBeAg loss”. TDF monotherapy was “well tolerated” during the course of the study, they say, with no patient reducing their dose or discontinuing the drug early. And no incidences of ALT flares or rises in creatinine or serum phosphorus levels were reported. Pan et al point out, however, that postmarketing surveillance found an association between TDF t r e a t m e n t a n d n e p h r o t o x i c i t y, i n c l u d i n g hypophosphatemia and renal insufficiency or failure, and suggest that renal function be monitored during long-term TDF therapy. They conclude: “Our findings suggest that suboptimal responders to [lamivudine] plus ADV should be switched as soon as possible to antiviral agents with higher potency, and TDF would be a viable option.” medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2015 Free full text http://www.wjgnet.com/1007-9327/full/v21/i9/2746.htm Medwire Newsは、Springer Healthcareが運営している医療業界者向けの独立性の高いニュースサイトです。2000年からサービスを開始し、注目すべきニュースを1日平均20本配信しています。Medwire News編集部では、国際的に認知されているジャーナル（学術誌）の論文、国際学会の速報、医療基礎研究の報告を情報ソースとしています。これらのニュースは、急速に発展をする医療開発や臨床試験の現場に向けて最新の研究結果をお伝えすることを目的に、経験豊かなメディカル・エディターによって最新かつ信頼できるニュースを配信しています。掲載されたニュースには海外で実施された試験が含まれており、本邦で承認されている効能・効果および用法・用量とは異なる場合があります。掲載の情報は第3者機関により提供されており、グラクソ・スミスクライン株式会社が内容について関与するものではありません。日本語レビューの精度については細心の注意を払っておりますが、その情報の正確性、通用性、完全性については、いかなる責任を負うものではなく、保証するものではありません。