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Prediction of sustained response after nucleo(s)tide analogue cessation using HBsAg and HBcrAg levels – A multicenter study (CREATE)

Clinical Gastroenterology and Hepatology Dec 13, 2020

Sonneveld MJ, Park JY, Kaewdech A, et al. - In this investigation involving patients who stopped nucleo(s)tide analogue (NA) therapy in centers in Asia and Europe, researchers intended to determine if there is an association between end-of-treatment levels of hepatitis B core related antigen (HBcrAg) and surface antigen (HBsAg) and outcome after discontinuation of therapy. At treatment termination, HBcrAg and HBsAg were measured, and correlations with off-treatment outcomes were examined. Five hundred seventy-two patients were analyzed, 457 (80%) were Asian and 95 (17%) were HBeAg positive at the start of NA therapy. Off-treatment results after NA cessation differed with ethnicity in this multicenter study. In non-Asian patients, VR (67% vs 42%) and HBsAg loss (15% vs 1.5%) was seen more frequently. In both Asian and non-Asian patients, lower SCALE-B scores were associated with higher rates of VR, HBsAg loss and lower rates of ALT flares. Favorable outcomes were correlated with lower HBcrAg and HBsAg levels. For risk stratification, a risk score comprising both factors may be used.

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