Comparison of the efficacy and safety of entecavir and tenofovir in nucleos(t)ide analogue-naive chronic hepatitis B patients with high viraemia: a retrospective cohort study

Wu, I-Wen; Hu, Tsung Hui; Hung, Chao Hung; Lu, Sheng; Wang, J.-H.; Lee, C.-M.; Chen, Chia Hsiang

doi:10.1016/j.cmi.2017.02.001

Cited by 35 publications

(38 citation statements)

References 33 publications

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“…In the overall propensity‐matched pairs, the two treatment groups were also not significantly different regarding the risk of liver‐related death or LT, HCC and other hepatic complications. Moreover, the efficacies of ETV and TDF were satisfactory and consistent with those of previous studies, and adequate for analysing clinical outcomes: VR was achieved in 89.5% of all patients and only 2.2% (15 ETV patients and 16 TDF patients) experienced VBT.…”

Section: Discussionsupporting

confidence: 87%

“…The clinical outcomes, in other words, the incidence of long‐term hepatic complications under long‐term antiviral therapy, are difficult to monitor because cirrhotic complications and HCC take a long time to develop, especially in noncirrhotic patients. Thus, in most clinical trials, VR, biochemical response and histologic response have been used as study endpoints to determine treatment efficacy . However, whether these endpoints can reflect long‐term clinical outcomes is unclear and few studies have directly compared the long‐term clinical outcomes of ETV and TDF.…”

Section: Discussionmentioning

confidence: 99%

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Mortality, liver transplantation and hepatic complications in patients with treatment‐naïve chronic hepatitis B treated with entecavir vs tenofovir

Kim

Park

Lee

et al. 2018

Journal of Viral Hepatitis

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Few studies have directly compared the long-term clinical outcomes of entecavir (ETV) and tenofovir disoproxil fumarate (TDF). This study aimed to compare the risk of mortality, liver transplantation and hepatic complications including hepatocellular carcinoma (HCC) and hepatic decompensation between these drugs in treatment-naïve chronic hepatitis B (CHB). We performed a longitudinal observational analysis of data from 1325 consecutive adult CHB patients with a cumulative adherence of ≥80% to treatment with ETV (n = 721) or TDF (n = 604) at a tertiary referral hospital in Ulsan, Korea, from 1 January 2007 through 31 April 2017. Among the patients, 708 were analysed using propensity score matching with a ratio of 1:1. In the follow-up period of up to 5 years, five patients (0.4%) died, three patients (0.2%) underwent liver transplantation (LT) and 54 patients (4.1%) developed HCC. Hepatic decompensation occurred in 24 (1.8%) patients. ETV therapy did not significantly differ from TDF therapy regarding the risk of liver-related death or LT (HR 0.96; 95% CI, 0.23-4.07; log-rank P = 0.955), HCC (HR, 1.36; 95% CI, 0.72-2.56; log-rank P = 0.340) and hepatic decompensation (HR, 1.64; 95% CI, 0.67-4.00; log-rank P = 0.276). In the 708 propensity-matched pairs, ETV and TDF were also not significantly different with respect to the risk of mortality, LT and hepatic complications. In this longitudinal observational study of 1325 patients with CHB, ETV and TDF therapies were not significantly different regarding the risk of mortality, HCC, LT and hepatic decompensation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Mortality, liver transplantation and hepatic complications in patients with treatment‐naïve chronic hepatitis B treated with entecavir vs tenofovir

Kim

Park

Lee

et al. 2018

Journal of Viral Hepatitis

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“…For HBV‐associated HCC patients, the status of HBeAg and HBV‐DNA load were two most important index to assess the viral status. With the advance of antiviral drugs like entecavir and tenofovir, HBV‐DNA seroconversion is achievable; however, these drugs rarely eradicate virus with a low rate of HBeAg seroconversion . The role of positive serum HBeAg, a surrogate marker of viral replication, deserves to be further studied.…”

Section: Discussionmentioning

confidence: 99%

“…With the advance of antiviral drugs like entecavir and tenofovir, HBV-DNA seroconversion is achievable; however, these drugs rarely eradicate virus with a low rate of HBeAg seroconversion. 24 The role of positive serum HBeAg, a surrogate marker of viral replication, deserves to be further studied. Active inflammation in the noncancerous liver tissue creates a microenvironment favouring metastatic tumour recurrence and poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

Shen

Liu

et al. 2018

Journal of Viral Hepatitis

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The effects of serum hepatitis B e antigen (HBeAg) on the prognosis of hepatocellular carcinoma (HCC) patients after hepatectomy remain controversial. Our aim was to explore the prognostic significance of serum HBeAg on the prognosis of patients with HCC using a propensity matching model. Between January 2009 and March 2015, 953 patients with HCC who underwent hepatectomy in West China Hospital were analysed. Propensity matching analysis was applied, and survival analysis was performed using the Kaplan-Meier method. Risk factors were identified by the Cox proportional hazards model. All patients with HCC were classified into an HBeAg(-) group (n = 775, 81.3%) or an HBeAg(+) group (n = 178, 18.7%). Patients with positive serum HBeAg had poorer recurrence-free survival and overall survival before and after propensity matching. Similar results were found in patients within the Milan criteria. For patients beyond the Milan criteria, the HBeAg(+) group had poor overall survival before and after propensity matching. In term of recurrence-free survival, there was no statistically significant impact after propensity matching (P = .055), although there was a trend for HBeAg(+) patient to have reduced recurrence-free survival. Positive serum HBeAg, positive HBV-DNA load, largest tumour size, multiple tumours, microvascular invasion and a high serum level of preoperative alpha-fetoprotein were risk factors for recurrence. Our propensity model confirmed that positive serum HBeAg had a negative impact on the recurrence and long-term survival irrespective of tumour stages. HBeAg seroconversion might be beneficial for reducing the rate of recurrence.

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“…В исследовании Wu и соавт. СКФ при лечении тенофовиром в течение 3 лет снизилась в среднем на 6,5 мл/мин [22]. Мы также отметили снижение СКФ (в среднем на 12,3 мл/мин) и повышение уровня креатинина сыворотки (в среднем на 14 мкмоль/л) при лечении тенофовиром в течение 5 лет.…”

Section: Discussionunclassified

S afety and adherence to the long-term treatment with nucleoside and nucleotide analogues in patients with chronic hepatitis B

Abdurakhmanov¹,

Nikulkina²,

Rozina³

et al. 2018

Clin Pharmacol Ther

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Comparison of the efficacy and safety of entecavir and tenofovir in nucleos(t)ide analogue-naive chronic hepatitis B patients with high viraemia: a retrospective cohort study

Abstract: Tenofovir and entecavir have similar effectiveness in NA-naive CHB patients with high viraemia. Tenofovir might have a higher incidence of acute kidney injury compared with entecavir during treatment.

Cited by 35 publications

References 33 publications

Mortality, liver transplantation and hepatic complications in patients with treatment‐naïve chronic hepatitis B treated with entecavir vs tenofovir

Mortality, liver transplantation and hepatic complications in patients with treatment‐naïve chronic hepatitis B treated with entecavir vs tenofovir

The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

S afety and adherence to the long-term treatment with nucleoside and nucleotide analogues in patients with chronic hepatitis B

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