A brand new examine finds that switching from long-term TDF to BSV might enhance renal and bone security, with no variations noticed within the antiviral efficacy. Credit score: Dr. Hyung Joon Yim from Korea College Ansan hospital
Hepatitis B is a liver an infection attributable to the hepatitis B virus (HBV), and long-term hepatitis B infections that last more than six months are thought-about “chronic.” Power hepatitis B (CHB) poses an enormous well being care burden as it’s a widespread reason behind continual liver illness and can be related to the event of liver cirrhosis and liver most cancers.
The antiviral tenofovir disoproxil fumarate (TDF) is at present probably the most extensively used therapy for CHB. Nevertheless, long-term therapy with TDF causes a gradual lower in kidney perform and bone well being, making it essential to discover safer long-term therapy choices.
Besifovir dipivoxil maleate (BSV) is one other drug that has been proven to have an antiviral efficacy akin to TDF in a stage 3 medical trial, with improved kidney and bone security in handled sufferers. Nevertheless, this examine was completed on people who had by no means obtained therapy for CHB—in the true world, most sufferers with CHB are already being handled with TDF, presumably for a number of years.
To deal with this limitation, a multicenter analysis crew led by Dr. Hyung Joon Yim from the Division of Inside Medication, Korea College Ansan hospital, Korea has studied the consequences of switching from long-term TDF to the antiviral BSV in sufferers with CHB, as a part of a stage 4 medical trial. In a examine printed on-line on 16 January 2025 in Medical and Molecular Hepatology, they enrolled 153 sufferers with CHB who have been receiving TDF therapy for 48 weeks or extra. These sufferers have been then randomly chosen to obtain both BSV or TDF for one more 48 weeks.
The primary intention on this examine was to substantiate that BSV was not inferior to TDF by way of antiviral efficacy. This was examined by measuring the quantity of HBV DNA within the sufferers’ blood. Amongst all of the sufferers who accomplished their allotted therapy, the examine discovered that 100% and 98.5% of sufferers receiving BSV and TDF respectively confirmed a virologic response in opposition to HBV, with very low virus ranges to not be detected within the blood by delicate assay.
“We also noted no antiviral resistance after switching from TDF to BSV,” provides Dr. Yim.
Extra importantly, the researchers confirmed that sufferers who switched to BSV confirmed, on common, the next proportion of change in a parameter known as estimated glomerular filtration charge, which signifies improved kidney functioning. The group handled with BSV additionally had greater hip and backbone bone density, indicating improved bone energy.
“These results show that adverse effects of long-term TDF may be potentially reversible with improved kidney function and bone density after switching to BSV,” says Dr. Yim, highlighting the potential of BSV as a safer long-term remedy for hepatitis B. “It seems that long term treatment with BSV would be a viable option for patients with CHB,” he provides. These findings provide new hope for sufferers present process long-term antiviral therapy for hepatitis B.
Extra data:
Hyung Joon Yim et al, Switching to Besifovir in Sufferers with Power Hepatitis B Receiving Tenofovir Disoproxil Fumarate: A Randomized Trial, Medical and Molecular Hepatology (2025). DOI: 10.3350/cmh.2024.0819
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Antiviral besifovir could also be a safer different for long-term hepatitis B therapy (2025, March 24)
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