Telbivudine in the treatment of chronic hepatitis B.
Treatment of chronic hepatitis B with oral nucleos(t)ide analogs is evolving rapidly with newer compounds gaining approval. Recently, the US FDA and European Medicines Agency (EMEA) have approved telbivudine, a potent anti-hepatitis B virus (HBV)-specific agent with a hitherto excellent safety profile. This review focuses on the efficacy of this agent in chronic hepatitis B compared with lamivudine, evaluated clinically in Phase II and a large Phase III study. Monitoring of the virologic response under treatment with sensitive HBV-DNA assays has been applied, aiming at increasing efficacy and reducing HBV resistance. The results are critically presented and the evolving concept of effective long-term telbivudine and other nucleos(t)ide analog therapy, predicted by the extent of suppression of HBV replication at week 24, are analyzed and discussed.
Hadziyannis
Stephanos J
SJ
Department of Medicine and Hepatology, Henry Dunant Hospital, 107 Messogion Avenue, 115 26 Athens, Greece. hadziyannis@ath.forthnet.gr
Vassilopoulos
Dimitrios
D
D024882:Drug Resistance, Viral; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D009705:Nucleosides / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives
D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D013936:Thymidine