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Comparative renal safety assessment of the hepatitis B drugs, adefovir, tenofovir, telbivudine and entecavir in rats

Uteng, Marianne and Mahl, Joerg Andreas and Beckmann, Nicolau and Piaia, Alessandro and Ledieu, David and Dubost, Valerie and Tritto, Elaine and Wolf, Armin and Moulin, Pierre and Li, Li and Chibout, Salah-Dine and Pognan, Francois (2016) Comparative renal safety assessment of the hepatitis B drugs, adefovir, tenofovir, telbivudine and entecavir in rats. Comparative renal safety assessment of the hepatitis B drugs, adefovir, tenofovir, telbivudine and entecavir in rats, 155 (1). pp. 283-297.

Abstract

The aim of this study was to determine the relative safety of four antiviral drugs (telbivudine, tenofovir, adefovir, entecavir) against hepatitis B virus with respect to kidney function and toxicity in male Spraque-Dawley rats. The antiviral drugs were administered once daily for four weeks by oral gavage at about 10 and 25-40 times the human equivalent dose. Main assessments included markers of renal toxicity in urine, magnetic resonance imaging (MRI) of kidney function, histopathology and electron microscopic examination. Administration of adefovir at 11 and 28 mg/kg for 4 weeks caused functional and morphological kidney alterations in a time- and dose-dependent manner, affecting mainly the proximal tubules and suggesting a mechanism of toxicity related to mitochondrial degeneration/depletion. Of note, the observed adefovir-induced reduction of kidney function was not detected by the standard method of glomerular filtration rate (GFR) measurements (clearance rate of the endogenous marker, creatinine), thereby emphasizing the superiority of MRI in terms of sensitive detection of GFR in rats. For the low dose of 300 mg/kg of tenofovir, minor kidney effects such as nuclear enlargement in the tubular epithelium, and hyaline droplets accumulation were detected, which was also observed for the low dose (11 mg/kg) of adefovir. No assessments could be done at the higher dose of 600/1000 mg/kg tenofovir due to gastrointestinal tract toxicity which prevented treatment of the animals for longer than 1 week. Entecavir at 1 and 3 mg/kg and telbivudine at 600 and 1600 mg/kg caused no toxicologically relevant effects on the kidney.

Item Type: Article
Date Deposited: 01 Feb 2017 00:45
Last Modified: 01 Feb 2017 00:45
URI: https://oak.novartis.com/id/eprint/29648

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