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, Beom Kyung

doi:10.1016/j.jhep.2019.10.012

Cited by 5 publications

(14 citation statements)

References 13 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The search strategy originally generated 2555 relevant clinical records from five databases. After the screening and eligibility assessment phase, a total of 11 eligible studies 13, 16–25 were selected for this meta‐analysis, including 70 864 patients. The detailed search and study selection process are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of tenofovir versus entecavir on reducing incidence of hepatocellular carcinoma in chronic hepatitis B patients: A systematic review and meta‐analysis

Yao

Shen

et al. 2020

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim: Studies had shown that tenofovir (TDF) and entecavir (ETV) are widely used as the first-line therapy to inhibit hepatitis B virus replication, which can reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it was unclear which nucleos(t)ide analogue was most effective. Therefore, we performed a meta-analysis and a systematic review to compare the incidence of HCC in CHB patients who are either on TDF or ETV. Methods: For this study, the following databases were searched for clinical trials published from its inception until November 2019: PubMed, Web of Science, MEDLINE, Embase, and Cochrane Library. Results: A total of 11 eligible studies were selected, including 70 864 patients. The meta-analysis showed that TDF was superior to ETV with regard to the incidence of HCC, the incidence of death or transplantation, and virologic response. There were no significant differences in terms of biochemical response and loss of seroconversion response among the entire cohort. Conclusions: The conclusion was that CHB patients treated with TDF had a reduced incidence of HCC compared with patients treated with ETV.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Using the data from the 11 studies that were selected, 13,16–25 we examined the incidence of HCC in 46 708 CHB patients, of which 7269 patients were in the TDF group and 39 439 patients were in the ETV group. According to the I 2 analyses ( P < 0.01, I 2 = 76%), we selected a random effect model to analyze the data.…”

Section: Resultsmentioning

confidence: 99%

Comparison of tenofovir versus entecavir on reducing incidence of hepatocellular carcinoma in chronic hepatitis B patients: A systematic review and meta‐analysis

Yao

Shen

et al. 2020

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…Previous literature reported that not only the virological response at a specific time point 6 , 7 but also low-level viremia during NA treatment 8 was associated with higher risk of HCC. However, previous studies investigating the impact of TDF on the incidence of HCC did not assess dynamic change of viral replication status during the treatment period 1 , 2 . In addition, we selected patients prescribed with the either drug from 2010 to minimise the effect of unmeasured potential confounders, such as difference in medical practice that may vary by time.…”

Section: Discussionmentioning

confidence: 99%

“…A Korean nationwide cohort study identified that TDF, compared to entecavir (ETV), was associated with a lower incidence of hepatocellular carcinoma (HCC) 1 . However, a subsequent Korean multicentre study contrastively reported no difference in HCC between the two nucleos(t)ide analogues (NAs) 2 .…”

Section: Introductionmentioning

confidence: 97%

Hepatocellular carcinoma and death and transplantation in chronic hepatitis B treated with entecavir or tenofovir disoproxil fumarate

Chon

Lee

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Conflicting results have been reported regarding which of entecavir (ETV) or tenofovir disoproxil fumarate (TDF) is associated with better outcomes. Chronic hepatitis B patients who started ETV or TDF between 2010 and 2015 were analysed. The primary outcomes were hepatocellular carcinoma and death and transplantation. The impact of the treatment on the primary outcomes was analysed using Cox proportional hazards models in the entire and propensity score-matched cohorts. A total of 404 patients (180 and 224 in the ETV and TDF groups, respectively) were analysed. The median duration of follow-up was significantly longer in the ETV group (64.0 vs. 49.1 months; P < 0.001). Virological response (79.4% vs. 68.4%; P = 0.018) and sustained virological suppression (59.7% vs. 45.2%; P = 0.005) were significantly higher in the TDF group. TDF was associated with lower hepatocellular carcinoma [hazard ratio (HR) 0.31, 95% confidence interval (95% CI), 0.12-0.79; P = 0.014]; however, statistical significance was not reached after adjusting sustained virological suppression using propensity score matching (HR 0.36, 95% CI 0.12-1.14; P = 0.08). Death and transplantation was comparable. In conclusion, the impact of TDF on the lower hepatocellular carcinoma was blunted after adjusting sustained virological suppression. Further comparison in a larger number of patients who show sustained virological suppression over a longer period of time is needed.

show abstract

“…Entecavir can be tri-phosphorylated and compete with the natural substrate used for DNA synthesis (guanosine triphosphate). Furthermore, entecavir displays a high degree of specificity for HBV [3,4]. In a phase III clinical trial of Chinese patients with chronic type B hepatitis (CHB), the ratio of HBV clearance (HBV DNA level decreased to below the lower limit of detection) was 76%, 79%, and 89%, after 48, 96, and 144 weeks, respectively, of treatment [5–8].…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Serum Entecavir Concentration and Virological Response in Patients with Chronic Type B Hepatitis

Gong

Peng³

et al. 2019

Med Sci Monit

View full text Add to dashboard Cite

Departmental sources Background: This study was conducted to investigate the relationship between trough concentrations of serum entecavir and the virological response of patients with chronic type B hepatitis (CHB). Material/Methods: A total of 59 CHB patients who had been receiving antiviral therapy with entecavir for >3 months were included in this study. Serum entecavir concentrations, HBV DNA levels, and other biochemical indicators were determined after drug treatments. Results: The serum entecavir concentrations in the good response and poor response groups were 0.58±0.38 and 0.43±0.15 ng/mL, respectively. The antiviral efficacy was 52.38%, 65.63%, and 100% in low, middle, and high entecavir groups, respectively. The baseline HBV DNA level among the patients with poor response was significantly higher than in the group with good response. Among the 14 patients with a high viral load, 5 patients showed a good response and had a higher entecavir concentration than the other 9 patients with poor response. Entecavir in patients with cirrhosis was higher than in those without cirrhosis (0.63±0.45 ng/mL vs. 0.46±0.16 ng/mL), and the virological response rate in patients with cirrhosis was higher than in those without cirrhosis (83.33 vs. 51.43%). Cirrhosis progression was reversed in 3 patients with high serum entecavir concentration. Conclusions: Serum entecavir concentrations vary among individuals, and higher serum entecavir concentration is correlated with more efficient viral clearance. Therefore, for patients with poor response, high doses may be beneficial for viral clearance.

show abstract

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”

Cited by 5 publications

References 13 publications

Comparison of tenofovir versus entecavir on reducing incidence of hepatocellular carcinoma in chronic hepatitis B patients: A systematic review and meta‐analysis

Comparison of tenofovir versus entecavir on reducing incidence of hepatocellular carcinoma in chronic hepatitis B patients: A systematic review and meta‐analysis

Hepatocellular carcinoma and death and transplantation in chronic hepatitis B treated with entecavir or tenofovir disoproxil fumarate

Correlation Between Serum Entecavir Concentration and Virological Response in Patients with Chronic Type B Hepatitis

Contact Info

Product

Resources

About