Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.

LY Mak; J Hoang; DW Jun; Chih-Hung Chen; CY Peng; ML Yeh; SE Kim; DQ Huang; JY Jeong; E Yoon; H Oh; PC Tsai; CF Huang; SB Ahn; H Trinh; Q Xie; GLH Wong; M Enomoto; JJ Shim; DH Lee; L Liu; R Kozuka; YK Cho; SW Jeong; HS Kim; L Trinh; A. Dao; R Huang; RW Hui; V Tsui; S Quek; HHTW Khine; E Ogawa; CY Dai; JF Huang; R Cheung; C Wu; WL Chuang; SG Lim; ML Yu; MF Yuen; MH Nguyen

doi:10.1007/s12072-021-10271-x

Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.

LY Mak, J Hoang, DW Jun, Chih-Hung Chen, CY Peng, ML Yeh, SE Kim, DQ Huang, JY Jeong, E Yoon, H Oh, PC Tsai, CF Huang, SB Ahn, H Trinh, Q Xie, GLH Wong, M Enomoto, JJ Shim, DH LeeL Liu, R Kozuka, YK Cho, SW Jeong, HS Kim, L Trinh, A. Dao, R Huang, RW Hui, V Tsui, S Quek, HHTW Khine, E Ogawa, CY Dai, JF Huang, R Cheung, C Wu, WL Chuang, SG Lim, ML Yu, MF Yuen, MH Nguyen

School of Medicine

Research output: Contribution to journal › Journal Article › peer-review

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Abstract

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). 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 m) 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). 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. Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.

Original language	American English
Journal	Hepatology International
Volume	16
Issue number	1
DOIs	https://doi.org/10.1007/s12072-021-10271-x
State	Published - 2022

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Mak, LY., Hoang, J., Jun, DW., Chen, C.-H., Peng, CY., Yeh, ML., Kim, SE., Huang, DQ., Jeong, JY., Yoon, E., Oh, H., Tsai, PC., Huang, CF., Ahn, SB., Trinh, H., Xie, Q., Wong, GLH., Enomoto, M., Shim, JJ., ... Nguyen, MH. (2022). Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study. Hepatology International, 16(1). https://doi.org/10.1007/s12072-021-10271-x

@article{b34f9aa923e041738ed866be5ea64450,

title = "Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.",

abstract = "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). This is a retrospective study of 6189 adult treatment-na{\"i}ve 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 m) 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). 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. Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.",

author = "LY Mak and J Hoang and DW Jun and Chih-Hung Chen and CY Peng and ML Yeh and SE Kim and DQ Huang and JY Jeong and E Yoon and H Oh and PC Tsai and CF Huang and SB Ahn and H Trinh and Q Xie and GLH Wong and M Enomoto and JJ Shim and DH Lee and L Liu and R Kozuka and YK Cho and SW Jeong and HS Kim and L Trinh and A. Dao and R Huang and RW Hui and V Tsui and S Quek and HHTW Khine and E Ogawa and CY Dai and JF Huang and R Cheung and C Wu and WL Chuang and SG Lim and ML Yu and MF Yuen and MH Nguyen",

year = "2022",

doi = "10.1007/s12072-021-10271-x",

language = "American English",

volume = "16",

journal = "Hepatology International",

issn = "1936-0533",

publisher = "Springer",

number = "1",

}

Mak, LY, Hoang, J, Jun, DW, Chen, C-H, Peng, CY, Yeh, ML, Kim, SE, Huang, DQ, Jeong, JY, Yoon, E, Oh, H, Tsai, PC, Huang, CF, Ahn, SB, Trinh, H, Xie, Q, Wong, GLH, Enomoto, M, Shim, JJ, Lee, DH, Liu, L, Kozuka, R, Cho, YK, Jeong, SW, Kim, HS, Trinh, L, Dao, A, Huang, R, Hui, RW, Tsui, V, Quek, S, Khine, HHTW, Ogawa, E, Dai, CY, Huang, JF, Cheung, R, Wu, C, Chuang, WL, Lim, SG, Yu, ML, Yuen, MF & Nguyen, MH 2022, 'Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.', Hepatology International, vol. 16, no. 1. https://doi.org/10.1007/s12072-021-10271-x

TY - JOUR

T1 - Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.

AU - Mak, LY

AU - Hoang, J

AU - Jun, DW

AU - Chen, Chih-Hung

AU - Peng, CY

AU - Yeh, ML

AU - Kim, SE

AU - Huang, DQ

AU - Jeong, JY

AU - Yoon, E

AU - Oh, H

AU - Tsai, PC

AU - Huang, CF

AU - Ahn, SB

AU - Trinh, H

AU - Xie, Q

AU - Wong, GLH

AU - Enomoto, M

AU - Shim, JJ

AU - Lee, DH

AU - Liu, L

AU - Kozuka, R

AU - Cho, YK

AU - Jeong, SW

AU - Kim, HS

AU - Trinh, L

AU - Dao, A.

AU - Huang, R

AU - Hui, RW

AU - Tsui, V

AU - Quek, S

AU - Khine, HHTW

AU - Ogawa, E

AU - Dai, CY

AU - Huang, JF

AU - Cheung, R

AU - Wu, C

AU - Chuang, WL

AU - Lim, SG

AU - Yu, ML

AU - Yuen, MF

AU - Nguyen, MH

PY - 2022

Y1 - 2022

N2 - 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). 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 m) 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). 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. Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.

AB - 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). 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 m) 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). 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. Over the 10-year study follow-up, compared to ETV, TDF was associated with a lower mean eGFR and higher incidence of renal impairment.

U2 - 10.1007/s12072-021-10271-x

DO - 10.1007/s12072-021-10271-x

M3 - Journal Article

C2 - 34822056

SN - 1936-0533

VL - 16

JO - Hepatology International

JF - Hepatology International

IS - 1

ER -

Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study.

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