Economic Analysis and Budget Impact of Tenofovir and Entecavir in the First-Line Treatment of Hepatitis B Virus in Italy

Tenofovir disoproxil fumarate (TDF) is an antiretroviral drug widely used as a first-line treatment of hepatitis B virus (HBV) and HIV. Increasing evidence has emerged associating its use with the development of Fanconi syndrome, renal insufficiency and bone disease. We report a case of a 61-year-old woman with a remote history of liver transplant for cirrhosis due to HBV. Over 1 year, the patient had recurrent falls, generalised myalgias and arthralgias, misdiagnosed as fibromyalgia. We discuss a complication of her transplant treatment regimen with the drug TDF leading to a rare but reversible disorder: tenofovir-induced Fanconi osteomalacia with renal phosphate wasting. Though recognised, this rare disorder was initially likely missed due to clinical unfamiliarity with the diagnosis, concomitant psychiatric symptoms and premature diagnostic closure.

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Economic Analysis of First-Line Treatment with Cetuximab or Panitumumab for RAS Wild-Type Metastatic Colorectal Cancer in England

PharmacoEconomics ◽

10.1007/s40273-018-0630-9 ◽

2018 ◽

Vol 36 (7) ◽

pp. 837-851 ◽

Cited By ~ 7

Author(s):

Irina A. Tikhonova ◽

Nicola Huxley ◽

Tristan Snowsill ◽

Louise Crathorne ◽

Jo Varley-Campbell ◽

...

Keyword(s):

Colorectal Cancer ◽

Economic Analysis ◽

Metastatic Colorectal Cancer ◽

Line Treatment ◽

Wild Type ◽

First Line ◽

First Line Treatment

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First-line treatment of chronic hepatitis B

Hepatitis C and B ◽

10.4324/9780203357187_chapter_27 ◽

2010 ◽

pp. 117-118

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Line Treatment ◽

First Line ◽

First Line Treatment

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First‐line treatment of chronic hepatitis B with entecavir or tenofovir in ‘real‐life’ settings: from clinical trials to clinical practice

Journal of Viral Hepatitis ◽

10.1111/j.1365-2893.2012.01602.x ◽

2012 ◽

Vol 19 (6) ◽

pp. 377-386 ◽

Cited By ~ 77

Author(s):

S. Pol ◽

P. Lampertico

Keyword(s):

Clinical Trials ◽

Chronic Hepatitis ◽

Clinical Practice ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Real Life ◽

Line Treatment ◽

First Line ◽

First Line Treatment

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Prognostic implications of hepatitis B virus infection in intrahepatic cholangiocarcinoma treated with first-line gemcitabine plus cisplatin

The International Journal of Biological Markers ◽

10.1177/1724600818777239 ◽

2018 ◽

Vol 33 (4) ◽

pp. 432-438

Author(s):

Heejung Chae ◽

Hyungwoo Cho ◽

Changhoon Yoo ◽

Kyu-pyo Kim ◽

Jae Ho Jeong ◽

...

Keyword(s):

Overall Survival ◽

Hepatitis B Virus ◽

Virus Infection ◽

Hepatitis B ◽

Intrahepatic Cholangiocarcinoma ◽

Hepatitis B Virus Infection ◽

First Line ◽

Poor Overall Survival ◽

Virus Group ◽

B Virus

Purpose: Hepatitis B virus infection is a well-known risk factor for intrahepatic cholangiocarcinoma. However, its prognostic impact has rarely been investigated in advanced intrahepatic cholangiocarcinoma. Methods: Between April 2010 and May 2015, 296 patients with unresectable or metastatic intrahepatic cholangiocarcinoma who received gemcitabine plus cisplatin (GemCis) were categorized into a hepatitis B virus group (n=62; 21%) and a non-hepatitis B virus group (n=234; 79%). Clinicopathological features and survival outcomes were retrospectively reviewed and analyzed. Results: The median age of patients was 59 years (range, 27–78). The median overall survival with first-line GemCis was 9.4 months (95% CI 8.4, 10.4). Compared to the non-hepatitis B virus group, the hepatitis B virus group was younger (median age, 57 vs. 61 years, P = 0.001), mainly male (74% vs. 57%, P = 0.02), and had lower frequency of elevated cancer antigen (CA) 19-9 (34% vs. 59%, P = 0.001) and alkaline phosphatase (43% vs. 61%, P = 0.01). In a univariate analysis, the hepatitis B virus infection showed a marginal relationship with poor overall survival compared to the non-hepatitis B virus infection (median, 8.3 vs. 10.0 months; P=0.13). A multivariate analysis of potential prognostic factors revealed a significant association with poor overall survival in the hepatitis B virus group (hazard ratio (HR) =1.50, P = 0.02). Initial metastatic disease (vs. recurrent/unresectable disease; HR=1.50), metastatic sites ⩾ 2 (vs. 0–1; HR=1.51), Eastern Cooperative Oncology Group performance status ⩾ 2 (vs. 0–1; HR=1.93), elevated total bilirubin (vs. normal; HR=1.83), and low albumin (vs. normal; HR=1.52) were significantly related to an unfavorable overall survival. Conclusions: This study suggests that the hepatitis B virus infection may be associated with distinctive clinicopathological characteristics and poor outcome in advanced intrahepatic cholangiocarcinoma treated with GemCis.

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