Telbivudine

Telbivudine
Clinical data
Trade names	Tyzeka
Other names	1-(2-deoxy-β-L-ribofuranosyl)-5-methyluracil; β-L-2-deoxythymidine; β-L-thymidine (LdT); 1-[(2S,4R,5S)-4-hydroxy-5-hydroxymethyltetrahydrofuran-2-yl]-5-methyl-1H-pyrimidine-2,4-dione
AHFS/Drugs.com	Monograph
MedlinePlus	a607045
License data	EU EMA: by INN; US FDA: Tyzeka;
Pregnancy; category	US: B (No risk in non-human studies) ;
Routes of; administration	Oral
ATC code	J05AF11 (WHO) ;
Legal status
Legal status	UK: POM (Prescription only) ; US: ℞-only ;
Pharmacokinetic data
Protein binding	Low (3.3% in vitro)
Metabolism	Nil
Elimination half-life	40 to 49 hours (terminal phase)
Excretion	Renal
Identifiers
	IUPAC name 1-(2-deoxy-β-L-erythro-pentofuranosyl)-5-methylpyrimidine-2,4(1H,3H)-dione;
CAS Number	3424-98-4 ;
PubChem CID	159269;
DrugBank	DB01265 ;
ChemSpider	140081 ;
UNII	2OC4HKD3SF;
ChEMBL	ChEMBL374731 ;
CompTox Dashboard (EPA)	DTXSID30187813 ;
ECHA InfoCard	100.125.511
Chemical and physical data
Formula	C10H14N2O5
Molar mass	242.231 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C/1NC(=O)N(\C=C\1C)[C@H]2O[C@H]([C@H](O)C2)CO;
	InChI InChI=1S/C10H14N2O5/c1-5-3-12(10(16)11-9(5)15)8-2-6(14)7(4-13)17-8/h3,6-8,13-14H,2,4H2,1H3,(H,11,15,16)/t6-,7+,8+/m1/s1 ; Key:IQFYYKKMVGJFEH-CSMHCCOUSA-N ;
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Telbivudine is an antiviral drug used in the treatment of hepatitis B infection. It is marketed by Swiss pharmaceutical company Novartis under the trade names Sebivo (Europe) and Tyzeka (United States). Clinical trials have shown it to be significantly more effective than lamivudine or adefovir, and less likely to cause resistance.[1][2][3] However, HBV signature resistance mutation M204I (a change from methionine to isoleucine at position 204 in the reverse transcriptase domain of the hepatitis B polymerase) or L180M+M204V have been associated with Telbivudine resistance.[4]

Telbivudine is a synthetic thymidine β-L-nucleoside analogue; it is the L-isomer of thymidine. Telbivudine impairs hepatitis B virus (HBV) DNA replication by leading to chain termination. It differs from the natural nucleotide only with respect to the location of the sugar and base moieties, taking on an levorotatory configuration versus a dextrorotatory configuration as do the natural deoxynucleosides.[5] It is taken orally in a dose of 600 mg once daily with or without food.

References

Lai CL, Leung N, Teo EK, et al. (2005). "A 1-year trial of telbivudine, lamivudine, and the combination in patients with hepatitis B e antigen-positive chronic hepatitis B". Gastroenterology. 129 (2): 528–36. doi:10.1016/j.gastro.2005.05.053. PMID 16083710.
Lai CL, Gane E, Liaw YF, et al. (2007). "Telbivudine versus lamivudine in patients with chronic hepatitis B". N Engl J Med. 357 (25): 2576–88. doi:10.1056/NEJMoa066422. hdl:10722/57525. PMID 18094378.
Chan HL, Heathcote EJ, Marcellin P, et al. (4 December 2007). "Treatment of hepatitis B e antigen positive chronic hepatitis with telbivudine or adefovir: a randomized trial". Ann Intern Med. 147 (11): 745–54. doi:10.7326/0003-4819-147-11-200712040-00183. PMID 17909201.
Osborn MK (2009). "Safety and efficacy of telbivudine for the treatment of chronic hepatitis B". Ther Clin Risk Manag. 5: 789–98. doi:10.2147/tcrm.s5318. PMC 2762437. PMID 19851526.
Osborn MK. "Safety and efficacy of telbivudine for the treatment of chronic hepatitis B". Ther Clin Risk Manag. 5: 789–98. PMC 2762437. PMID 19851526.

External links

Tyzeka official website run by Novartis Pharmaceuticals Corporation
Telbivudine entry in RxList
Sebivo Summary of Product Characteristics (from the EMEA website)

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[Lai1-1] Lai CL, Leung N, Teo EK, et al. (2005). "A 1-year trial of telbivudine, lamivudine, and the combination in patients with hepatitis B e antigen-positive chronic hepatitis B". Gastroenterology. 129 (2): 528–36. doi:10.1016/j.gastro.2005.05.053. PMID 16083710.

[NEJM-2] Lai CL, Gane E, Liaw YF, et al. (2007). "Telbivudine versus lamivudine in patients with chronic hepatitis B". N Engl J Med. 357 (25): 2576–88. doi:10.1056/NEJMoa066422. hdl:10722/57525. PMID 18094378.

[3] Chan HL, Heathcote EJ, Marcellin P, et al. (4 December 2007). "Treatment of hepatitis B e antigen positive chronic hepatitis with telbivudine or adefovir: a randomized trial". Ann Intern Med. 147 (11): 745–54. doi:10.7326/0003-4819-147-11-200712040-00183. PMID 17909201.

[4] Osborn MK (2009). "Safety and efficacy of telbivudine for the treatment of chronic hepatitis B". Ther Clin Risk Manag. 5: 789–98. doi:10.2147/tcrm.s5318. PMC 2762437. PMID 19851526.

[5] Osborn MK. "Safety and efficacy of telbivudine for the treatment of chronic hepatitis B". Ther Clin Risk Manag. 5: 789–98. PMC 2762437. PMID 19851526.