To compare the efficacy and renal safety of tenofovir alafenamide (TAF) versus entecavir (ETV) in the chronic hepatitis B patients.
With high antiviral potency and low drug resistance rate, both ETV and tenofovir disoproxil fumarate (TDF) have been recommended as the first-line antiviral therapy for chronic hepatitis B (CHB). However, risk of renal dysfunction remains an issue in TDF long-term therapy. Tenofovir alafenamide (TAF) is a novel prodrug of tenofovir and is formulated to deliver the active metabolite to target cells more efficiently than TDF at lower doses, thereby reducing systemic exposure to tenofovir. Importantly, TAF had improved renal safety as compared to TDF. TAF has been approved for treating CHB since 2017; however, it is still unknown whether the efficacy and renal safety of TAF is compatible to those of ETV. The investigators aim to conduct an open label, randomized controlled trial comparing TAF with ETV for assessing their efficacy and renal safety in CHB patients. The eligible CHB patients are randomly assigned (1:1) to receive TAF or ETV. After allocation to TAF group or ETV group, study subjects will receive therapy for 3 years (144 weeks).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
140
Tenofovir alafenamide 25mg/tab once daily
Entecavir 0.5mg/tab once daily
Taichung Veterans General Hospital
Taichung, Taichung, Taiwan
RECRUITINGHBV viral suppression
proportion of patients with hepatitis B virus(HBV) -DNA suppression
Time frame: After 48-week therapy of Tenofovir alafenamide or entecavir
Renal safety: Change of estimated glomerular filtration rate
Change of estimated glomerular filtration rate
Time frame: After 48-week therapy of Tenofovir alafenamide or entecavir
Renal safety: Change of estimated glomerular filtration rate
Change of estimated glomerular filtration rate
Time frame: After 144-week therapy of Tenofovir alafenamide or entecavir
HBV viral suppression
proportion of patients with hepatitis B virus(HBV) -DNA suppression
Time frame: After 144-week therapy of Tenofovir alafenamide or entecavir
Normalization alanine aminotransferase (ALT)
proportion of patients with ALT normalization
Time frame: After 144-week therapy of Tenofovir alafenamide or entecavir
HBsAg loss
proportion of patients with HBsAg loss
Time frame: After 144-week therapy of Tenofovir alafenamide or entecavir
Bone mineral density
change of bone mineral density
Time frame: After 144-week therapy of Tenofovir alafenamide or entecavir
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.