— Christine M. Kukka, Project Manager, HBV Advocate
Researchers in China have found that a combination of the antivirals
adefovir (Hepsera) and entecavir (Baraclude) is more effective in
patients who have developed resistance to lamivudine (Epivir-HBV) than a
combination of lamivudine plus adefovir.
Lamivudine was the first antiviral developed for
hepatitis B treatment, but doctors found that patients quickly develop
drug resistance to this antiviral. The second antiviral ever approved
for hepatitis B was adefovir. Historically, after patients developed
lamivudine resistance, doctors added adefovir to the treatment mix to
boost its strength.
Each antiviral attacks a different part of the
hepatitis B virus and doctors hoped the combination of lamivudine plus
adefovir would effectively lower viral load. However, a retrospective
analysis of studies into what drug combination worked best in
lamivudine-resistant patients found that the adefovir plus entecavir
pairing worked best.
After six months, the patients on
adefovir-plus-entecavir achieved undetectable HBV DNA and normal
alanine transaminase (ALT) levels (indicating no liver damage) faster.
After 12 months, the entecavir-plus-adefovir group had lower rates of
HBV DNA resurgence and drug resistance, according to the report
published in the June issue of the Journal of Clinical Pharmacology.
Source: www.ncbi.nlm.nih.gov/pubmed/24964070
Labels: Entecavir + adefovir, lamivudine resistance
