Comment on – A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea

Yu, Yiqi; Zhang, Junyan; Zhang, Bozheng; Gao, Xin

doi:10.1016/j.jhep.2019.09.027

Journal of Hepatology

2020

DOI: 10.1016/j.jhep.2019.09.027

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Comment on – A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea

Yiqi Yu

Junyan Zhang²,

Bozheng Zhang³

et al.

Abstract: Comment on-A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea To the Editor: We read with great interest the article, 'A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea' by Kim et al., published in the Journal of Hepatology. 1 The authors concluded that the risk of hepatocellular carcinoma (HCC) and death or orthotopic liver transplant was no different between ent… Show more

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Reply to: “Comparison of risk of hepatocellular carcinoma between tenofovir and entecavir: One direction or no direction”

Kim

2019

Journal of Hepatology

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patients and outcome events to ensure statistical power. Showing non-significance in clinical outcomes between the 2 treatments is easier than identifying statistically significant differences in comparative effectiveness research. 5 This may explain why many previous studies, including the study of Kim et al., have shown no significant difference in risk of HCC among drugs. 1,6-8 Collectively, it is important to note that all the studies that compared the risk of HCC between TDF and ETV therapies have indicated one direction favoring TDF or no direction. No study has shown the opposite direction of favoring ETV over TDF. 6-8 Even the study by Kim et al. also indicated a lower risk of HCC with TDF in patients with cirrhosis (hazard ratio 0.85; HCC incidence at 5 years of treatment, 16.0% with TDF vs. 20.9% with ETV), although the difference was not statistically significant. A meta-analysis consisting of 7 studies (3,698 patients) reported a lower incidence of HCC in patients with TDF than in those with ETV. 9 Recently, another large historical cohort study from Hong Kong showed a significantly lower risk of HCC in TDF than in ETV. 10 Given that a randomized clinical trial, which is the optimum for this topic, cannot be conducted in the future, we have to depend heavily on the results of observational studies. Accordingly, caution is required in interpreting the results from observational studies, considering whether they have sufficient numbers of patients and outcome events, with high internal validity in study design and analysis.

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Reply to: “Comparison of risk of hepatocellular carcinoma between tenofovir and entecavir: One direction or no direction”

Kim

2019

Journal of Hepatology

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Reply to: “Comment on – A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea”

Kim

2020

Journal of Hepatology

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Comment on – A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea

Cited by 2 publications

References 13 publications

Reply to: “Comparison of risk of hepatocellular carcinoma between tenofovir and entecavir: One direction or no direction”

Reply to: “Comparison of risk of hepatocellular carcinoma between tenofovir and entecavir: One direction or no direction”

Reply to: “Comment on – A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea”

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