OBJECTIVES

Tenofovir alafenamide (TAF), a novel prodrug that reduces tenofovir plasma levels, is one of agents recommended for the treatment of patients with chronic hepatitis B infection (CHB). Compared to tenofovir disoproxil fumarate (TDF), TAF with less renal toxicity is recommend for long-term treatment. However, head-to-head comparison of these agents remained limited in the real-world clinical practice. So, the aim of our study was to analyzed renal function change between TDF and TAF.

METHODS

We retrospectively identified a cohort of CHB patients newly initiating TDF or TAF between January 2019 and December 2019 from Chang Gung Research Database, a multi-institutional electronic medical records database covering approximately 1.3 million individuals (6% of the Taiwan population). The safety outcome included estimated Glomerular filtration rate (eGFR) change from baseline to 6-month follow-up. We followed patients from initiation of TDF or TAF to death, last clinical visit or June 30, 2020. The eGFR change from baseline in each group was testing by pair t-test.

RESULTS

We identified 1,135 patients for each group receiving TDF or TAF. The mean age was 55.6 (SD 12.2) years old and 30.6% were female. The baseline eGFR were 94.1 (SD 38.3) and 89.1 (SD 33.4) ml/min/1.73m² among TDF or TAF users, respectively. The eGFR changes from baseline were -4.1 (SE 1.9) and -4.2 (SE 1.2) among TDF or TAF users, respectively. There was no significantly difference between TDF and TAF.

CONCLUSIONS

Our finding showed that the renal toxicity of TDF and TAF was similar during the short-term follow-up period. Further long-term and large scale real-world study was suggested to confirm our finding.