Comparison of the Efficacy of Entecavir and Tenofovir in Reducing Hepatocellular Carcinoma Risk in Chronic Hepatitis B Patients: A Real-Life Study in Turkey

Lower risk of hepatocellular carcinoma with tenofovir than entecavir treatment in subsets of chronic hepatitis B patients: an updated meta‐analysis

“…2A). In the 21 studies [9][10][11][12][13][14][15][16][17][18][19][20]22,[24][25][26][27][28][45][46][47] reporting aHR, the pooled aHR was 0.81 (95% CI: 0.72-0.91) with significant heterogeneity (I 2 = 47%, P = 0.007) as well (Fig. 2b).…”

“…The uHRs for Asian CHB patients could be derived from 19 studies. [9][10][11][12][13][14][15][16][17][18][21][22][23]26,28,29,[45][46][47] The pooled uHR was 0.74 (95% CI: 0.66-0.84) and the pooled aHR was 0.76 (95% CI: 0.66-0.87). In seven studies from Europe or the USA, 13,16,19,20,24,25,27 TDF and ETV had similar risk of HCC incidence, with uHR of 0.92 (95% CI: 0.75-1.13) and aHR of 0.93 (95% CI: 0.75-1.16) (Fig.…”

“…In nine studies in which follow-up duration was > 12-months longer in ETV-treated than TDF-treated patients, 10,12,[15][16][17]22,26,29,47 the HCC incidence was significantly lower in the TDF group (uHR, 0.68; 95% CI: 0.58-0.79; aHR, 0.71; 95% CI: 0.64-0.79). Moreover, in studies with difference of follow-up duration < 12 months between the two groups, 9,13,14,[18][19][20][23][24][25]27,28,45,46 TDF group had slightly lower rate of HCC incidence than ETV group (uHR, 0.85; 95% CI: 0.73-0.99) (aHR, 0.89; 95% CI: 0.76-1.04). In eight studies with median follow-up of both groups > 48 months, 14,15,18,20,[23][24][25]27 TDF-treated and ETV-treated patients had similar HCC incidence, with pooled uHR of 0.95 (95% CI: 0.82-1.10) and pooled aHR of 0.99 (95% CI: 0.84-1.16).…”

“…Type of data source. Pooling data from 23 studies using data from cohorts and not national registries, [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]29,[45][46][47] TDF compared with ETV treated patients had significantly lower HCC incidence using uHR (pooled uHR, 0.78; 95% CI: 0.68-0.88) and aHR (pooled aHR, 0.85; 95% CI: 0.76-0.95). Pooling the data from the two national registries 12,28 TDF-treated patients also had a trend of lower HCC incidence (uHR, 0.56; 95% CI: 0.32-1.00) (aHR, 0.52; 95% CI: 0.26-1.03) (Fig.…”

Overview of methodologies and statistical strategies in observational studies and meta-analyses on the risk of hepatocellular carcinoma in patients with chronic hepatitis B on entecavir or tenofovir therapy

“…PS is considered as a balancing score that balances the two treatment groups on their confounding factors. Traditionally, PS is estimated by binary logistic regression, while the use of machine learning classification algorithms such as decision tree and gradient boosting has also been studied to incorporate nonlinear relationships between the confounding factors and the treatment assignment [21,22] . In this article, a cohort of 100 TDF-treated patients and 900 ETVtreated patients with chronic hepatitis B is simulated to illustrate the use of PS, PS matching/weighting algorithm, balance diagnostics of the distribution of clinical characteristics between ETV-and TDF-treated patients before and after PS matching/weighting, as well as the impact of the presence of competing risk on the estimation of cumulative incidence of HCC.…”