ArticleJournal of Korean medical science2025
Comparative Renal Safety of Besifovir Dipivoxil Maleate and Tenofovir Disoproxil Fumarate in Chronic Hepatitis B Patients: Insights From a Nationwide Cohort Study.
Article in Journal of Korean medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBesifovir dipivoxil maleate (BSV) is a novel antiviral agent approved in Korea for chronic hepatitis B (CHB) treatment. While previous comparative studies between BSV and tenofovir disoproxil fumarate (TDF) have suggested lower renal toxicity in BSV, these findings were limited by small sample sizes. This study aimed to comprehensively assess the incidence of chronic kidney disease (CKD) in CHB patients treated with BSV versus TDF using a nationwide cohort.
methodsIn this retrospective cohort study, we analyzed treatment-naïve CHB patients who initiated BSV or TDF therapy between January 2018 and December 2022. Using the South Korean national health database, we created balanced cohorts of 19,959 patients in the BSV group and 19,991 patients in the TDF group through inverse probability of treatment weighting (IPTW). The primary outcome was determined by CKD incidence.
resultsThe incidence rate (IR) of CKD was lower in the BSV group than in the TDF group (2.29 vs. 3.42 per 1,000 person-years; incidence rate ratio [IRR], 1.50; 95% confidence interval [CI], 1.18-1.89;
conclusionBSV is linked to a lower incidence of CKD than TDF, particularly in patients aged 60 and older, suggesting BSV may be a safer treatment option in elderly patients at high risk of renal impairment.
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