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Efficacy of entecavir switching therapy in chronic hepatitis B patients with clevudine-induced myopathy클레부딘 근육병증이 발생한 만성 B형간염 환자들에서 엔테카비어 전환 치료의 효과

Other Titles
클레부딘 근육병증이 발생한 만성 B형간염 환자들에서 엔테카비어 전환 치료의 효과
Authors
이지원이영준이종준김정호정영걸권오상최덕주김연수김주현
Issue Date
Jan-2013
Publisher
대한소화기학회
Keywords
클레부딘; 엔테카비어; B형간염; 근육병증; Clevudine; Entecavir; Chronic hepatitis B; Muscular diseases
Citation
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, v.61, no.1, pp.30 - 36
Journal Title
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume
61
Number
1
Start Page
30
End Page
36
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14818
DOI
10.4166/kjg.2013.61.1.30
ISSN
1598-9992
Abstract
Clevudine is a potent antiviral agent against HBV. However, long-term clevudine therapy may cause myopathy. This study was carried out to identify the efficacy of entecavir switching therapy in chronic hepatitis B patients experiencing clevudine-induced myopathy. One hundred forty six patients with chronic hepatitis B treated with 30 mg of clevudine per day for 73 weeks (range, 36-132 weeks) were enrolled. Among them, clevudine-induced myopathy occurred in 21 patients (14.4%) which was diagnosed if the patients had symptoms related to myopathy with concurrent CK and AST elevation. All the patients who were diagnosed as clevudine-induced myopathy stopped the therapy, and 17 patients (81%) were switched to entecavir 0.5 mg. The patients with clevudine-induced myopathy were switched to entecavir 0.5 mg for median 68 weeks, and all of them showed disappearance of clinical myopathic symptoms and normalization of CK and AST level within median 2.2 months. Eight patients (47%) were HBeAg positive before entecavir treatment, and HBeAg seroconversion was achieved in 2 patients (25%). HBV DNA level was elevated in 3 patients (17.6%) at the time when the patients were diagnosed as myopathy, all of them achieved virological response with entecavir switching therapy. ALT level was elevated in 3 patients (17.6%) before entecavir treatment, all of them showed normalization of ALT level. During entecavir therapy, genotypic resistance to entecavir or virological breakthrough was not noted. In chronic hepatitis B patients experiencing clevudine-induced myopathy, switching to entecavir 0.5 mg per day showed a resolution of myopathy and adequate viral suppression.
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