Drugs and Clinic Practice

Comparison of clinical efficacy of TMF and TDF in the treatment of hepatitis B liver fibrosis

  • Yingyuan ZHANG ,
  • Chunyan MOU ,
  • Danqing XU ,
  • Yuanzhen WANG ,
  • Lixian CHANG ,
  • Chunyun LIU ,
  • Weikun LI ,
  • Hongyan WEI ,
  • Li LIU
Expand
  • Yunnan Infectious Disease Clinical Medical Center of Kunming Third People's Hospital,Kunming 650041,Yunnan,China

Received date: 2024-08-05

  Online published: 2024-11-25

Abstract

Objective This study is to explore the clinical efficacy and common adverse reactions of PEG?IFN α ?2b combined with TMF and TDF in the treatment of hepatitis B liver fibrosis, and provide more clinical reference for the treatment of chronic hepatitis B. Methods From January 2022 to December 2023, we selected 130 patients with chronic hepatitis B liver fibrosis who were admitted to Kunming Third People's Hospital. Divided into TMF combined group and TDF combined group, the virus reduction level, virus response rate, liver fibrosis four items, instantaneous elastography (FibroScan) and other indicators were compared between the two groups of patients after 48 weeks of treatment. The changes in liver fibrosis grading and adverse reactions before and after treatment were also compared. Results After 48 weeks of treatment, the TMF combined group showed a significant increase in HBV DNA seroconversion rate and HBeAg seroconversion rate compared to the TDF combined group, with statistical significance (P < 0.05). However, there was no statistically significant difference in HBsAg seroconversion rate between the two groups of patients (P > 0.05). After 48 weeks of treatment, the TMF combined group showed more significant efficacy in reducing the levels of HA, PC Ⅲ, Ⅳ?C, and LN, with a significant difference (P < 0.05); After 48 weeks of treatment, both groups of patients showed improvement in the degree of liver tissue fibrosis. Compared with the TDF combined group, the TMF combined group had a more significant effect on tissue improvement. After 48 weeks of treatment, the incidence of dyslipidemia, hypothyroidism, and diarrhea was higher in the TMF combined group than in the TDF combined group (P < 0.05); After 48 weeks of treatment, there was no statistically significant difference in the incidence of gingival bleeding, anemia, and thrombocytopenia between the two groups of patients (P > 0.05); The incidence of elevated uric acid and joint pain in the TDF combined group was higher than that in the TMF combined group after 48 weeks of treatment (P < 0.05). Conclusion TMF combined with PEG?IFN α ?2b has better clinical efficacy in treating chronic hepatitis B, strong antiviral ability, greater inhibition of liver fibrosis, good drug safety, better prognosis, and can provide more effective medication basis for clinical cure of hepatitis B.

Cite this article

Yingyuan ZHANG , Chunyan MOU , Danqing XU , Yuanzhen WANG , Lixian CHANG , Chunyun LIU , Weikun LI , Hongyan WEI , Li LIU . Comparison of clinical efficacy of TMF and TDF in the treatment of hepatitis B liver fibrosis[J]. The Journal of Practical Medicine, 2024 , 40(22) : 3215 -3220 . DOI: 10.3969/j.issn.1006-5725.2024.22.016

References

1 尤红,王福生,李太生,等.慢性乙型肝炎防治指南(2022年版)[J]. 实用肝脏病杂志,2023,26(3): 457-478.
2 ZHAO Q, LIU H, TANG L, et al. Mechanism of interferon alpha therapy for chronic hepatitis B and potential approaches to improve its therapeutic efficacy[J]. ANTIVIR RES,2023,221:105782. doi:10.1016/j.antiviral.2023.105782
3 OGUNNAIKE M, DAS S, RAUT SS, et al. Chronic Hepatitis B Infection: New Approaches towards Cure[J]. Biomolecules,2023,13(8):1208. doi:10.3390/biom13081208
4 HONG X, CAI Z, ZHOU F, et al.Improved pharmacokinetics of tenofovir ester prodrugs strengthened the inhibition of HBV replication and the rebalance of hepatocellular metabolism in preclinical models[J].Front Pharmacol, 2022,8(13):932-934.
5 ZHAO C, WANGLIU Y. Uncovering the mechanism of Tenofovir amibufenamide fumarate punch sticking by combining direct compression experiment and computational simulation[J]. Int J Pharmaceut, 2024,653(4):123813. doi:10.1016/j.ijpharm.2024.123813
6 LI L, ZHOU J, LI Y, et al. Effectiveness and safety of tenofovir amibufenamide and its comparison with tenofovir alafenamide in patients with chronic hepatitis B: Results from a retrospective real-world study[J]. Front Pharmacol, 2023, 6(14):1165990.
7 程能能. 我国首个原研口服抗HBV药物TMF结构优势解读——神奇的甲基化 [J].肝脏, 2021, 26(12): 1303-1305.
8 SHENG Q J, HAN C, LI Y W, et al. Clinical efficacy analysis of TMF for the treatment of hyperviremia HBeAg positive chronic hepatitis B patients with incomplete response to first-line oral antiviral nucleos(t)ide analogues[J]. Zhonghua Gan Zang Bing Za Zhi, 2023, 31(3): 252-257.
9 LIU L P, WU X P, CAI T P, et al. Analysis of efficacy and factors influencing sequential combination therapy with tenofovir alafenamide fumarate after treatment with entecavir in chronic hepatitis B patients with low-level viremia [J]. Zhonghua Gan Zang Bing Za Zhi, 2023,31(2): 118-125.
10 LIU Z, JIN Q, ZHANG Y, et al. Randomised clinical trial: 48 weeks of treatment with tenofovir amibufenamide versus tenofovir disoproxil fumarate for patients with chronic hepatitis B[J]. Aliment Pharm Therap,2021, 54(9): 1134-1149. doi:10.1111/apt.16611
11 AVICK N, SAUBHIK G, SOUVIK S, et al. A study on outcome of hepatic fibrosis in chronic hepatitis B patients on anti-viral therapy Asian [J]. Med Sci, 2024,15(2): 98-103. doi:10.3126/ajms.v15i2.59316
12 卢瑾,闻名,唐情容,等. 血清GP73、CHI3L1表达与慢性乙型肝炎患者肝纤维化及病理变化程度的关系 [J]. 实用医学杂志, 2024, 40(11): 1586-1591.
13 唐娟,李燚,翟丽琼,等. 外周血miR-571水平对肝纤维化的诊断价值[J]. 实用医学杂志, 2024, 40(5): 653-657.
14 Xu X, Jin J, Liu Y. Performance of FibroScan in grading steatosis and fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis[J]. Arab J Gastroenterol, 2023,24(4): 189-197. doi:10.1016/j.ajg.2023.08.003
15 徐蕊,何明钰,刘新峰,等. 磁共振新兴技术在肝纤维化的研究进展 [J]. 实用医学杂志, 2023, 39(1): 124-128.
16 SUZUKI K, SUDA G, YAMAMOTO Y,et al.Tenofovir-disoproxil fumarate modulates lipid metabolism via hepatic CD36/PPAR alpha activation in hepatitis B virus infection[J]. Gastroenterol,2021,56(2):168-180. doi:10.1007/s00535-020-01750-3
17 LI L, ZHOU J, LI Y, et al. Effectiveness and safety of tenofovir amibufenamide and its comparison with tenofovir alafenamide in patients with chronic hepatitis B: Results from a retrospective real-world study[J]. Front Pharmacol,2023,6(14):1165990.
18 LIAN J, KUANG W, JIA H, et al. Pegylated interferon-α-2b combined with tenofovir disoproxil fumarate, granulocyte-macrophage colony-stimulating factor, and hepatitis B vaccine treatment for na?ve HBeAg-positive chronic hepatitis B patients: A prospective, multicenter, randomized controlled study[J]. J Med Virol,2022,94(11):5475-5483. doi:10.1002/jmv.28003
19 LIU Z, JIN Q, ZHANG Y, et al.96-Week Treatment of Tenofovir Amibufenamide and Tenofovir Disoproxil Fumarate in Chronic Hepatitis B Patients[J]. J Clin Transl Hepato, 2022, 11(3): 649-660.
20 PENG W T, JIANG C, YANG F L, et al. Tenofovir amibufenamide vs tenofovir alafenamide for treating chronic hepatitis B: A real-world study[J]. WORLD J GASTROENTERO,2023, 29 (44): 5907-5918. doi:10.3748/wjg.v29.i44.5907
21 YANG Q. Clinical Efficacy and Incidence of Adverse Reactions of Entecavir Combined with Long-Acting Interferon in Treating Hepatitis B[J]. Jcnr, 2023,7(6):41-46. doi:10.26689/jcnr.v7i6.5632
22 LIU J, WU M, KAI J, et al. Effect of Food on the Pharmacokinetics of Tenofovir Amibufenamide: A Phase I, Randomized, Open-Label, Two-Period Crossover Trial in Healthy Adult Subjects[J]. Drug Des Devel Ther,2023,1(17):3061-3072.
23 JIANG P, JIA H, QIAN X, et al. Single-cell RNA sequencing reveals the immunoregulatory roles of PegIFN-α in patients with chronic hepatitis B[J]. Hepatology, 2023, 79(1): 167-182. doi:10.1097/hep.0000000000000524
Outlines

/