Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study
- Authors
- Mak, Lung-Yi; Hoang, Joseph; Jun, Dae Won; Chen, Chien-Hung; Peng, Cheng-Yuan; Yeh, Ming-Lun; Kim, Sung Eun; Huang, Daniel Q.; Jeong, Jae Yoon; Yoon, Eileen; Oh, Hyunwoo; Tsai, Pei-Chien; Huang, Chung-Feng; Ahn, Sang Bong; Trinh, Huy; Xie, Qing; Wong, Grace L. H.; Enomoto, Masaru; Shim, Jae-Jun; Lee, Dong-Hyun; Liu, Li; Kozuka, Ritsuzo; Cho, Yong Kyun; Jeong, Soung Won; Kim, Hyoung Su; Trinh, Lindsey; Dao, Allen; Huang, Rui; Hui, Rex Wan-Hin; Tsui, Vivien; Quek, Sabrina; Khine, Htet Htet Toe Wai; Ogawa, Eiichi; Dai, Chia Yen; Huang, Jee Fu; Cheung, Ramsey; Wu, Chao; Chuang, Wan-Long; Lim, Seng Gee; Yu, Ming-Lung; Yuen, Man-Fung; Nguyen, Mindie H.
- Issue Date
- Feb-2022
- Publisher
- SPRINGER
- Keywords
- Real-world study; Renal function; Chronic kidney disease; Long-term follow-up
- Citation
- HEPATOLOGY INTERNATIONAL, v.16, no.1, pp.48 - 58
- Indexed
- SCIE
SCOPUS
- Journal Title
- HEPATOLOGY INTERNATIONAL
- Volume
- 16
- Number
- 1
- Start Page
- 48
- End Page
- 58
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/139670
- DOI
- 10.1007/s12072-021-10271-x
- ISSN
- 1936-0533
- Abstract
- Background and aims
We aimed to compare the longitudinal changes in estimated glomerular filtration rate (eGFR) in chronic hepatitis B (CHB) patients treated with entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF).
Methods
This is a retrospective study of 6189 adult treatment-naïve CHB patients initiated therapy with TDF (n = 2482) or ETV (n = 3707) at 25 international centers using multivariable generalized linear modeling (GLM) to determine mean eGFR (mL/min/1.73 m2) and Kaplan–Meier method to estimate incidence of renal impairment (≥ 1 chronic kidney disease [CKD] stage worsening). We also examined above renal changes in matched ETV and TDF patients (via propensity score matching [PSM] on age, sex, diabetes mellitus [DM], hypertension [HTN], cirrhosis, baseline eGFR, and follow-up duration).
Results
In the overall cohort (mean age 49.7 years, 66.2% male), the baseline eGFR was higher for TDF vs. ETV group (75.9 vs. 74.0, p = 0.009). PSM yielded 1871 pairs of ETV or TDF patients with baseline eGFR ≥ 60 and 520 pairs for the eGFR < 60 group. GLM analysis of the overall (unmatched) cohort and PSM cohorts revealed lower adjusted mean eGFRs in TDF (vs. ETV) patients (all p < 0.01) during 10 years of follow-up. Among PSM eGFR ≥ 60 patients, the 5-year cumulative incidences of renal impairment were 42.64% for ETV and 48.03% for TDF (p = 0.0023). In multivariable Cox regression, TDF vs. ETV (adjusted HR 1.26, 95% CI 1.11–1.43) was associated with higher risk of worsening renal function.
Conclusion
Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.
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