AASLD 2019 — Switching from TDF to TAF improves bone, renal outcomes in hepatitis B


  • Brandon May
  • Conference Reports
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Takeaway

  • Patients with chronic hepatitis B who have risk factors for renal and bone effects associated with tenofovir disoproxil fumarate (TDF) have improvements in bone and renal safety parameters if they switch to tenofovir alafenamide (TAF).

Why this matters

  • The preferred treatment in most hepatitis B guidelines is TAF, particularly for patients with risk factors for TDF toxicities.
  • Little research has been conducted on switching to TAF from TDF in virally suppressed patients with chronic hepatitis B.

Study design

  • Patients virologically suppressed on TDF were randomly assigned to switch from TDF to TAF (n=180) or continue TDF (n=178) for 48 weeks.
  • Approximately 73% of patients had ≥1 risk factor for TDF.
  • Changes in renal and bone safety parameters, and antiviral efficacy were assessed at 48 weeks.
  • Funding: None reported.

Key results

  • Patients who switched to TAF from TDF had greater median improvements in renal parameters at 48 weeks, including serum creatinine (−0.01 vs +0.01 mg/dL; P=.001) and eGFRCG (+1.86 vs −2.70 mL/minute; P<.0001>
  • At 48 weeks, switching to TAF was associated with greater median improvements in hip (0.668% vs −0.527%; P<.0001 and spine vs p bone mineral density.>
  • Efficacy was maintained in both groups at 48 weeks (P=.96).

Limitations

  • There were more men (66%) and patients predominantly of Asian descent (80%).