2. Academic Validation
  3. Randomised clinical trial: 48 weeks of treatment with tenofovir amibufenamide versus tenofovir disoproxil fumarate for patients with chronic hepatitis B

Randomised clinical trial: 48 weeks of treatment with tenofovir amibufenamide versus tenofovir disoproxil fumarate for patients with chronic hepatitis B

  • Aliment Pharmacol Ther. 2021 Nov;54(9):1134-1149. doi: 10.1111/apt.16611.
Zhihong Liu 1,  Qinglong Jin 2,  Yuexin Zhang 3,  Guozhong Gong 4,  Guicheng Wu 5,  Lvfeng Yao 6,  Xiaofeng Wen 7,  Zhiliang Gao 1,  Yan Huang 4,  Daokun Yang 8,  Enqiang Chen 9,  Qing Mao 5,  Shide Lin 10,  Jia Shang 11,  Huanyu Gong 4,  Lihua Zhong 12,  Huafa Yin 13,  Fengmei Wang 14,  Peng Hu 5,  Ling Xiao 15,  Chuan Li 15,  Qiong Wu 15,  Chang'an Sun 15,  Junqi Niu 2,  Jinlin Hou 1,  TMF Study Group
Affiliations

Affiliations

  • 1 Guangzhou, China.
  • 2 Changchun, China.
  • 3 Urumchi, China.
  • 4 Changsha, China.
  • 5 Chongqing, China.
  • 6 Fuzhou, China.
  • 7 Liuzhou, China.
  • 8 Xinxiang, China.
  • 9 Chengdu, China.
  • 10 Zunyi, China.
  • 11 Zhengzhou, China.
  • 12 Harbin, China.
  • 13 Hefei, China.
  • 14 Tianjin, China.
  • 15 Lianyungang, China.
PMID: 34587302 DOI: 10.1111/apt.16611
Abstract

Background: Tenofovir amibufenamide (TMF) can provide more efficient delivery than tenofovir disoproxil fumarate (TDF).

Aim: To compare the efficacy and safety of TMF and TDF for 48 weeks in patients with chronic hepatitis B (CHB).

Methods: We performed a randomised, double-blind, non-inferiority study at 49 sites in China. Patients with CHB were assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo. The primary efficacy endpoint was the proportion of patients with hepatitis B virus (HBV) DNA less than 20 IU/mL at week 48. We also assessed safety, particularly bone, renal and metabolic abnormalities.

Results: We randomised 1002 eligible patients. The baseline characteristics were well balanced between groups. After a median 48 weeks of treatment, the non-inferiority criterion was met in all analysis sets. In the HBeAg-positive population, 50.2% of patients receiving TMF and 53.7% receiving TDF achieved HBV DNA less than 20 IU/mL. In the HBeAg-negative population, 88.9% and 87.8%, respectively, achieved HBV DNA less than 20 IU/mL in the TMF and TDF groups. Patients receiving TMF had significantly less decrease in bone mineral density at both hip (P < 0.001) and spine (P < 0.001), and a smaller increase in serum creatinine at week 48 (P < 0.05). Other safety results were similar between groups.

Conclusion: TMF was non-inferior to TDF in terms of anti-HBV efficacy and showed better bone and renal safety. (NCT03903796).

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