Lamivudine plus adefovir vs. entecavir in HBeAg-positive hepatitis B with sequential treatment failure of lamivudine and adefovir

Chang Young Son, Han Jak Ryu, Jung Min Lee, Sang Hoon Ahn, Do Young Kim, Myoung Ha Lee, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Aims: Few studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg-positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12. Methods: In total, 72 HBeAg-positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months. Results: Following 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6%) and 8/41 (19.5%; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6%) and 16/18 (88.9%; P = 0.566); HBeAg seroconversion in 1/31 (2.3%) and 4/41 (9.8%; P = 0.341) and a virologic breakthrough in 3/31 (9.0%) and 5/41 (12.1%; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV-DNA level (OR = 0.37; 95% CI 0.17-0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95% CI 0.83-0.95; P = 0.044). Conclusions: Neither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.

Original languageEnglish
Pages (from-to)1179-1185
Number of pages7
JournalLiver International
Volume32
Issue number7
DOIs
Publication statusPublished - 2012 Aug 1

Fingerprint

Lamivudine
Hepatitis B e Antigens
Hepatitis B
Treatment Failure
Therapeutics
lipoarabinomannan
adefovir
entecavir
Chronic Hepatitis B
DNA

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

@article{256744af27fe4de8b151f3687f8a5ed6,
title = "Lamivudine plus adefovir vs. entecavir in HBeAg-positive hepatitis B with sequential treatment failure of lamivudine and adefovir",
abstract = "Background and Aims: Few studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg-positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12. Methods: In total, 72 HBeAg-positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months. Results: Following 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6{\%}) and 8/41 (19.5{\%}; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6{\%}) and 16/18 (88.9{\%}; P = 0.566); HBeAg seroconversion in 1/31 (2.3{\%}) and 4/41 (9.8{\%}; P = 0.341) and a virologic breakthrough in 3/31 (9.0{\%}) and 5/41 (12.1{\%}; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV-DNA level (OR = 0.37; 95{\%} CI 0.17-0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95{\%} CI 0.83-0.95; P = 0.044). Conclusions: Neither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.",
author = "Son, {Chang Young} and Ryu, {Han Jak} and Lee, {Jung Min} and Ahn, {Sang Hoon} and Kim, {Do Young} and Lee, {Myoung Ha} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Park, {Jun Yong}",
year = "2012",
month = "8",
day = "1",
doi = "10.1111/j.1478-3231.2012.02793.x",
language = "English",
volume = "32",
pages = "1179--1185",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "7",

}

Lamivudine plus adefovir vs. entecavir in HBeAg-positive hepatitis B with sequential treatment failure of lamivudine and adefovir. / Son, Chang Young; Ryu, Han Jak; Lee, Jung Min; Ahn, Sang Hoon; Kim, Do Young; Lee, Myoung Ha; Han, Kwang Hyub; Chon, Chae Yoon; Park, Jun Yong.

In: Liver International, Vol. 32, No. 7, 01.08.2012, p. 1179-1185.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lamivudine plus adefovir vs. entecavir in HBeAg-positive hepatitis B with sequential treatment failure of lamivudine and adefovir

AU - Son, Chang Young

AU - Ryu, Han Jak

AU - Lee, Jung Min

AU - Ahn, Sang Hoon

AU - Kim, Do Young

AU - Lee, Myoung Ha

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Park, Jun Yong

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Background and Aims: Few studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg-positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12. Methods: In total, 72 HBeAg-positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months. Results: Following 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6%) and 8/41 (19.5%; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6%) and 16/18 (88.9%; P = 0.566); HBeAg seroconversion in 1/31 (2.3%) and 4/41 (9.8%; P = 0.341) and a virologic breakthrough in 3/31 (9.0%) and 5/41 (12.1%; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV-DNA level (OR = 0.37; 95% CI 0.17-0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95% CI 0.83-0.95; P = 0.044). Conclusions: Neither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.

AB - Background and Aims: Few studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg-positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12. Methods: In total, 72 HBeAg-positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months. Results: Following 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6%) and 8/41 (19.5%; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6%) and 16/18 (88.9%; P = 0.566); HBeAg seroconversion in 1/31 (2.3%) and 4/41 (9.8%; P = 0.341) and a virologic breakthrough in 3/31 (9.0%) and 5/41 (12.1%; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV-DNA level (OR = 0.37; 95% CI 0.17-0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95% CI 0.83-0.95; P = 0.044). Conclusions: Neither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.

UR - http://www.scopus.com/inward/record.url?scp=84863508763&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863508763&partnerID=8YFLogxK

U2 - 10.1111/j.1478-3231.2012.02793.x

DO - 10.1111/j.1478-3231.2012.02793.x

M3 - Article

C2 - 22452737

AN - SCOPUS:84863508763

VL - 32

SP - 1179

EP - 1185

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 7

ER -