“This [TAF] is a very good drug, a nice one to have at our disposal,” according to Dr. Terrault. “The primary reason we wanted it has to do with its safety profile.”
Its potential benefit in this regard was illustrated in a pair of multinational phase 3 clinical trials totaling nearly 1,300 patients with chronic HBV presented at the 2017 meeting of American Association for the Study of Liver Disease. After completing 96 weeks of double-blind treatment with TAF or TDF, everyone was switched to open-label TAF.
“There was a nice rebound in creatinine clearance and bone density when the switch was made from TDF to TAF,” she observed. “This is encouraging data for us, in that if you have a patient on TDF and you are concerned about renal or bone safety, you can do the switch to TAF and very quickly see some recovery in those abnormalities.”
Dr. Terrault offered the following guidance in selecting HBV therapy: For most patients with no comorbidities, monotherapy with either TAF, TDF, or entecavir is an excellent approach.