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Article: Tenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B

TitleTenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B
Authors
Issue Date2020
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at https://journals.lww.com/ajg/pages/default.aspx
Citation
The American Journal of Gastroenterology, 2020, v. 115 n. 2, p. 271-280 How to Cite?
AbstractINTRODUCTION: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases. RESULTS: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26–0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42–1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41–1.92; P = 0.77). DISCUSSION: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.
Persistent Identifierhttp://hdl.handle.net/10722/284489
ISSN
2023 Impact Factor: 8.0
2023 SCImago Journal Rankings: 2.391
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHsu, YC-
dc.contributor.authorWong, GLH-
dc.contributor.authorChen, CH-
dc.contributor.authorPeng, CY-
dc.contributor.authorYeh, ML-
dc.contributor.authorCheung, KS-
dc.contributor.authorToyoda, H-
dc.contributor.authorHuang, CF-
dc.contributor.authorTrinh, H-
dc.contributor.authorXie, Q-
dc.contributor.authorEnomoto, M-
dc.contributor.authorLiu, L-
dc.contributor.authorYasuda, S-
dc.contributor.authorTanaka, Y-
dc.contributor.authorKozuka, R-
dc.contributor.authorTsai, PC-
dc.contributor.authorHuang, YT-
dc.contributor.authorWong, C-
dc.contributor.authorHuang, R-
dc.contributor.authorJang, TY-
dc.contributor.authorHoang, J-
dc.contributor.authorYan, HI-
dc.contributor.authorLi, J-
dc.contributor.authorLee, DH-
dc.contributor.authorTakahashi, H-
dc.contributor.authorZhang, JQ-
dc.contributor.authorOgawa, E-
dc.contributor.authorZhao, C-
dc.contributor.authorLiu, C-
dc.contributor.authorFurusyo, N-
dc.contributor.authorEguchi, Y-
dc.contributor.authorWong, C-
dc.contributor.authorWu, C-
dc.contributor.authorKumada, T-
dc.contributor.authorYuen, MF-
dc.contributor.authorYu, ML-
dc.contributor.authorNguyen, M-
dc.date.accessioned2020-08-07T08:58:23Z-
dc.date.available2020-08-07T08:58:23Z-
dc.date.issued2020-
dc.identifier.citationThe American Journal of Gastroenterology, 2020, v. 115 n. 2, p. 271-280-
dc.identifier.issn0002-9270-
dc.identifier.urihttp://hdl.handle.net/10722/284489-
dc.description.abstractINTRODUCTION: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases. RESULTS: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26–0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42–1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41–1.92; P = 0.77). DISCUSSION: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.-
dc.languageeng-
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at https://journals.lww.com/ajg/pages/default.aspx-
dc.relation.ispartofThe American Journal of Gastroenterology-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.titleTenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B-
dc.typeArticle-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.14309/ajg.0000000000000428-
dc.identifier.pmid31634265-
dc.identifier.scopuseid_2-s2.0-85079018521-
dc.identifier.hkuros312205-
dc.identifier.volume115-
dc.identifier.issue2-
dc.identifier.spage271-
dc.identifier.epage280-
dc.identifier.isiWOS:000540835600021-
dc.publisher.placeUnited States-
dc.identifier.issnl0002-9270-

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