Tenofovir disoproxil fumarate in Chinese chronic hepatitis B patients: Results of a multicenter, double-blind, double-dummy, clinical trial at 96 weeks

Xiao-Fan Chen, Ya-Nan Fan, Chong-Wen Si, Yan-Yan Yu, Jia Shang, Zu-Jiang Yu, Qing Mao, Qing Xie, Wei Zhao, Jun Li, Zhi-Liang Gao, Shan-Ming Wu, Hong Tang, Jun Cheng, Xin-Yue Chen, Wen-Hong Zhang, Hao Wang, Zhong-Nan Xu, Ling Wang, Jun Dai, Jing-Hang Xu, Xiao-Fan Chen, Ya-Nan Fan, Chong-Wen Si, Yan-Yan Yu, Jia Shang, Zu-Jiang Yu, Qing Mao, Qing Xie, Wei Zhao, Jun Li, Zhi-Liang Gao, Shan-Ming Wu, Hong Tang, Jun Cheng, Xin-Yue Chen, Wen-Hong Zhang, Hao Wang, Zhong-Nan Xu, Ling Wang, Jun Dai, Jing-Hang Xu

Abstract

Background: Tenofovir disoproxil fumarate (TDF) is a prodrug of a nucleotide analogue. As an antiviral drug, TDF has been proposed in the first-line treatment of chronic hepatitis B (CHB). Qingzhong, a brand name of TDF, commercialized by Jiangsu Chia-tai Tianqing Pharmaceutical Co Ltd., and Viread, another brand name of TDF, commercialized by GlaxoSmithKline, have both been approved by the State Food and Drug Administration, China.

Aim: To investigate the efficacy and safety of the two TDF agents in the treatment of Chinese CHB patients.

Methods: This trial was registered at ClinicalTrials.gov with the identifier number of NCT02287857. A total of 330 Chinese CHB patients, among which 232 were hepatitis B e antigen (HBeAg)-positive, were included in this 5-year-long, multicenter, double-blinded, double-dummy, randomized-controlled, non-inferiority phase III trial. The participants were initially randomized into two groups: Group A (n = 161), in which the participants received 300 mg Qingzhong once a day for 48 wk; and Group B, in which the participants received 300 mg Viread once a day for 48 wk. Starting from week 49, all the participants in Groups A and B received 300 mg Qingzhong once a day until the 96th week. In this study, the primary endpoint was the decrease in plasma level of hepatitis B virus (HBV) DNA at the 96th week, while the secondary endpoints were suppression of HBV replication, alanine aminotransferase (ALT) normalization, HBeAg loss, and HBeAg seroconversion rates.

Results: For the participants with HBeAg-positive CHB, the decrease in mean HBV DNA level relative to the baseline value was comparable between Groups A and B (5.77 vs 5.73 log10 IU/mL, P > 0.05) at the 96th week. In addition, similar percentages of HBeAg-positive participants in the two groups exhibited undetectable levels of HBV DNA, HBeAg loss, and HBeAg seroconversion (71.05% vs 77.97%, 31.00% vs 27.27%, and 20.22% vs 15.79%, respectively, in Group A vs Group B; P > 0.05). For the participants with HBeAg-negative CHB, the decrease in mean HBV DNA level relative to the baseline value was also comparable between Groups A and B (4.46 vs 4.70 log10 IU/mL, P > 0.05) at the 96th week. In addition, similar percentages of HBeAg-negative participants in the two groups exhibited undetectable levels of HBV DNA (87.23% vs 94.12% in Group A vs Group B, respectively; P > 0.05). Finally, similar percentages of CHB patients (HBeAg-positive or HBeAg-negative) in the two groups exhibited normalization of ALT (80.14% vs 84.57% in Group A vs Group B, respectively; P > 0.05), and similar incidences of adverse events were observed (106 vs 104 in Group A vs Group B, respectively; P > 0.05).

Conclusion: Both Qingzhong and Viread are effective and safe in the treatment of Chinese CHB patients according to the results of our clinical trial.

Keywords: Chronic; Chronic hepatitis B; Hepatitis B virus infection; Noninferiority trial; Randomized, controlled trial; Tenofovir disoproxil fumarate; Treatment outcomes.

Conflict of interest statement

Conflict-of-interest statement: Nothing to declare.

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

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