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. 2016 Oct;61(10):3061-3071.
doi: 10.1007/s10620-015-3960-x. Epub 2015 Nov 14.

Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Chronic Hepatitis B: A 3-Year Prospective Field Practice Study in Germany

Jörg Petersen  1 , Renate Heyne  2 , Stefan Mauss  3 , Jörg Schlaak  4 , Willibald Schiffelholz  5 , Christoph Eisenbach  6 , Heinz Hartmann  7 , Manfred Wiese  8 , Klaus Boeker  9 , Hanns-Friedrich Loehr  10 , Christine John  11 , Maria Leuschner  12 , Christian Trautwein  13 , Gisela Felten  7 , Andreas Trein  14 , Wolfgang Krause  15 , Susanne Ruppert  16 , Tobias Warger  16 , Dietrich Hueppe  7
Affiliations

Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Chronic Hepatitis B: A 3-Year Prospective Field Practice Study in Germany

Jörg Petersen et al. Dig Dis Sci. 2016 Oct.

Abstract

Background and aims: Multiple clinical trials have demonstrated the efficacy and safety of tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB). However, long-term efficacy and safety data for TDF in real-life clinical practice are limited.

Methods: Prospective German field practice study in CHB-mono-infected patients. Patients were TDF-naïve but could have been treated previously with other HBV antivirals.

Results: Efficacy analysis included 400 patients; 301 (75 %) completed 36 months of TDF treatment. Both treatment-naïve and treatment-experienced patients showed a rapid decline in HBV DNA within 3 months of TDF initiation. After 36 months, HBV DNA < 69 IU/mL was achieved by 91 % of treatment-naïve patients (90 and 92 % in hepatitis B "e" antigen [HBeAg]-positive and [HBeAg]-negative, respectively) and 96 % of treatment-experienced patients (93 and 97 %, respectively). Three patients experienced virologic breakthrough, all with reported non-compliance. Overall, 5.7 % HBeAg-positive and 2.2 % HBeAg-negative patients lost hepatitis B surface antigen. Safety data were consistent with the known TDF safety profile; the most commonly reported adverse events possibly related to TDF were fatigue (2.0 %) and headache (2.0 %). Few patients (1.3 %) experienced renal-related adverse reactions. Creatinine clearance remained relatively stable over time; patients responded favorably where TDF was dose adjusted per label for decreased creatinine clearance.

Conclusions: TDF showed a favorable tolerability profile and induced rapid and sustained suppression of HBV DNA in patients with CHB treated for up to 3 years in routine clinical practice, irrespective of treatment history. Efficacy and safety in this heterogeneous patient population were consistent with data from clinical trials.

Keywords: Chronic hepatitis B; Clinical practice; Real world; Tenofovir disoproxil fumarate.

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