Lotte G van Vlerken1, Pauline Arends2, Faydra I Lieveld3, Joop E Arends4, Willem Pieter Brouwer2, Peter D Siersema1, Harry L Janssen5, Karel J van Erpecum6. 1. Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands. 2. Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. 3. Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands; Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands. 5. Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands; Liver Clinic, Toronto Western and General Hospital, University Health Network, Toronto, Canada. 6. Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands. Electronic address: K.J.vanErpecum@umcutrecht.nl.
Abstract
BACKGROUND: Real-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis B patients are scarce. AIMS: We investigated adherence to entecavir in relation to virological response. METHODS: In this prospective study, we provided 100 consecutive chronic hepatitis B patients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire. RESULTS: Adherence over 16 weeks averaged 85 ± 17%, with 70% of patients exhibiting good (i.e. ≥ 80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p=0.01), with more often indifferent attitudes towards entecavir (p=0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks > 20 IU/mL (n=18) and ≤ 20 IU/mL (n=81) averaged 83% and 91% respectively (p=0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p=0.34), after adjustment for duration of entecavir treatment (p<0.001) and HBe-status (p=0.001). CONCLUSIONS: 70% of chronic hepatitis B patients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response.
BACKGROUND: Real-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis Bpatients are scarce. AIMS: We investigated adherence to entecavir in relation to virological response. METHODS: In this prospective study, we provided 100 consecutive chronic hepatitis Bpatients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire. RESULTS: Adherence over 16 weeks averaged 85 ± 17%, with 70% of patients exhibiting good (i.e. ≥ 80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p=0.01), with more often indifferent attitudes towards entecavir (p=0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks > 20 IU/mL (n=18) and ≤ 20 IU/mL (n=81) averaged 83% and 91% respectively (p=0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p=0.34), after adjustment for duration of entecavir treatment (p<0.001) and HBe-status (p=0.001). CONCLUSIONS: 70% of chronic hepatitis Bpatients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response.
Authors: Nicole L Allard; Jennifer H MacLachlan; Anouk Dev; James Dwyer; Geeta Srivatsa; Timothy Spelman; Alexander J Thompson; Benjamin C Cowie Journal: BMC Gastroenterol Date: 2020-05-07 Impact factor: 3.067
Authors: Eun Ju Cho; Su Jong Yu; So Young Kwon; Ji-Hoon Kim; Do Young Kim; Won Kim; June Sung Lee; Jin Woo Lee; Youn Jae Lee; Hee Bok Chae; Jung-Hwan Yoon Journal: Drug Des Devel Ther Date: 2018-11-02 Impact factor: 4.162