Entecavir safety and effectiveness in a national cohort of treatment-naïve chronic hepatitis B patients in the US - The ENUMERATE study

J. Ahn, H. M. Lee, J. K. Lim, C. Q. Pan, M. H. Nguyen, W. Ray Kim, A. Mannalithara, H. Trinh, D. Chu, T. Tran, A. Min, S. Do, H. Te, K. R. Reddy, A. S. Lok

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Background Entecavir (ETV) has been shown to be safe and efficacious in randomised controlled trials in highly selected patients with hepatitis B virus (HBV) infection. Aim To determine the safety and effectiveness of ETV in 'real-world' HBV patients in the United States (US). Methods Treatment-naïve HBV patients ≥18 years old who received ETV for ≥12 months between 2005 and 2013 were included in a retrospective, cohort study. Rates of ALT normalisation, undetectable HBV DNA, HBeAg and HBsAg loss/seroconversion, adverse events (AE) and clinical outcomes were evaluated. Results Of 841 patients, 658 [65% male, 83% Asian; median age 47 years] met the inclusion criteria. 36% were HBeAg+ and 9.3% cirrhotic. 89% had abnormal ALT. Baseline median HBV DNA was 5.8 log 10 IU/mL. Median duration of ETV treatment was 4 years. Rates of ALT normalisation at 1, 3 and 5 years were 37.2%, 48.7% and 56.2% in HBeAg+ and 39.6%, 46.8% and 55.6% in HBeAg- patients. HBV DNA was undetectable at 1, 3 and 5 years in 34.6%, 64.7% and 84.6% in HBeAg+ patients, and 81.9%, 90.3% and 96.2% in HBeAg patients. Five-year cumulative probability of HBeAg loss and seroconversion was 46% and 33.7% and HBsAg loss was 4.6%. ETV was discontinued due to adverse events in 1.2% of patients. Hepatic decompensation occurred in 0.8%, liver cancer in 2.7% and death in 0.6%. Conclusion Entecavir treatment was safe in a large cohort of US patients, but ALT normalisation and hepatitis B virus DNA suppression rates were lower than previously reported in clinical trials.

Original languageEnglish (US)
Pages (from-to)134-144
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume43
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Entecavir safety and effectiveness in a national cohort of treatment-naïve chronic hepatitis B patients in the US - The ENUMERATE study'. Together they form a unique fingerprint.

  • Cite this

    Ahn, J., Lee, H. M., Lim, J. K., Pan, C. Q., Nguyen, M. H., Ray Kim, W., Mannalithara, A., Trinh, H., Chu, D., Tran, T., Min, A., Do, S., Te, H., Reddy, K. R., & Lok, A. S. (2016). Entecavir safety and effectiveness in a national cohort of treatment-naïve chronic hepatitis B patients in the US - The ENUMERATE study. Alimentary Pharmacology and Therapeutics, 43(1), 134-144. https://doi.org/10.1111/apt.13440