Randomized, placebo-controlled trial of tenofovir disoproxil fumarate in adolescents with chronic hepatitis B Hepatology, 05/03/2012

Murray KF et al. – Tenofovir disoproxil fumarate (tenofovir DF) therapy in hepatitis B virus (HBV)–infected adolescents was well tolerated and highly effective at suppressing HBV DNA and normalizing ALT values in both treatment–naïve adolescents and those with prior exposure to HBV therapy.

• In this double-blind, placebo-controlled trial, adolescents (12 to <18 years) with CHB were randomized to tenofovir DF 300 mg (n=52) or placebo (n=54) once daily for 72 weeks.
• The primary end point was virologic response (HBV DNA <400 copies/mL) at week 72.
• One hundred six patients were enrolled; 101 patients completed 72 weeks of treatment.
• At baseline, 91% of patients were hepatitis B e-antigen positive and 85% had prior exposure to HBV therapy.

• A virologic response was observed in 89% (46/52) of patients who received tenofovir DF and 0% (0/54) of patients who received placebo (P < 0.001).
• Treatment response was not affected by prior HBV treatment.
• Furthermore, no resistance to tenofovir DF developed through week 72.
• Among patients with an alanine aminotransferase (ALT) > upper limit of normal baseline, normalization of ALT occurred in 74% of patients receiving tenofovir DF and 31% of patients receiving placebo (P < 0.001).
• The rate of grade 3/4 adverse events was higher among patients treated with placebo (24%) than patients treated with tenofovir DF (10%).
• No patients met the safety end point of a 6% decrease in spine bone mineral density at week 72.