Clinical Medicine Insights: Therapeutics

Prista Charuworn and Emmet B. Keeffe

Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA, U.S.A.

Abstract

Chronic hepatitis B is a major global health problem. Fortunately there are currently a number of agents licensed in most countries to treat chronic hepatitis B, including the oral nucleos(t)ide agents lamivudine, adefovir, entecavir, telbivudine, and tenofovir, and the immune modulators interferon alfa-2b and peginterferon alfa-2a. Large clinical trials have shown potent suppression of viral replication with telbivudine and a good safety profile, and superiority of telbivudine over lamivudine and adefovir in head-to-head trials. The potential of resistance with use of telbivudine mandates careful monitoring and on-treatment strategies to avoid or reduce the development of resistance. This review article provides an overview of the pharmacokinetics, clinical efficacy, safety, and resistance profile of telbivudine.