Background: To overcome safety limitations of tenofovir-disoproxil, EASL guidelines proposed switching chronic hepatitis B patients older than 60 years or with bone or renal disease to tenofovir-alafenamide or entecavir. Aims: To estimate the number of patients who would benefit from a treatment switch in a real-life setting. Methods: Consecutive hepatitis B patients receiving tenofovir-disoproxil before 31 December 2017 were enrolled in a cross-sectional study in two European hospitals. Clinical and virological data were recorded; renal function was assessed by estimated glomerular filtrate rate, serum phosphate and creatinine, proteinuria, and albuminuria; bone involvement by spine and femur DEXA scan. Results: In total, 565 patients included: 62 (18–91) years, 75% males, 92% Caucasian, 92% HBeAg-negative, 40% cirrhotic. Fifty-five percent of patients fulfilled age criterion (>60 years). Older patients had higher rates of cirrhosis (51% vs 26%, p<0.001), cardiovascular disease, and renal impairment. Thirty-six percent of patients met renal criteria, more commonly NA-experienced individuals (35% vs 21%, p=0.001); 17% had bone disease. Overall, 66% of patients had at least one criterion (71% if NA-experienced), 8% all three criteria, 28% age and renal criteria. Conclusions: Approximately two-thirds of patients receiving long-term tenofovir-disoproxil are candidates for an entecavir or tenofovir-alafenamide switch according to EASL recommendations
Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide / L. Roade, A. Loglio, M. Borghi, M. Riveiro-Barciela, R. Soffredini, F. Facchetti, D. di Paolo, D. Tabernero, G. Lunghi, R. Esteban, M. Buti, P. Lampertico. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:10(2020), pp. 1164-1169.
|Titolo:||Application of EASL 2017 criteria for switching hepatitis B patients from tenofovir disoproxil to entecavir or tenofovir alafenamide|
|Parole Chiave:||Bone safety; ETV; HBV; Nucleos(t)ide analogues; Renal safety; TAF; TDF|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.dld.2020.06.037|
|Appare nelle tipologie:||01 - Articolo su periodico|