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Article: Entecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis
Title | Entecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis |
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Authors | |
Keywords | Hepatitis B E Antigen Entecavir Telbivudine |
Issue Date | 2020 |
Publisher | Nature Publishing Group: Open Access Journals - Option A. The Journal's web site is located at http://www.nature.com/ctg/index.html |
Citation | Clinical and Translational Gastroenterology, 2020, v. 11 n. 10, p. article no. e00236 How to Cite? |
Abstract | INTRODUCTION:
Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are recommended as first-line therapies for chronic hepatitis B (CHB) infection. Although both drugs reduce hepatocellular carcinoma (HCC) risk, their comparative effectiveness remains controversial. We aimed to determine whether TDF is superior to ETV in preventing HCC.
METHODS:
PubMed, Embase, and Cochrane Library from inception until June 9, 2020, were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Key terms included entecavir, tenofovir, and hepatocellular carcinoma. The adjusted hazard ratios (HRs) were pooled using a random effects model. Heterogeneity among studies was assessed by the Cochran Q test and I2.
RESULTS:
Thirteen observational studies (4 of which were conference abstracts) were included with 85,008 patients with CHB (ETV: 56,346; TDF: 28,662). TDF was associated with a lower HCC risk (adjusted HR [aHR]: 0.81; 95% confidence interval [CI]: 0.67–0.99). This beneficial effect was present in cirrhotic patients (aHR: 0.73; 95% CI: 0.62–0.85) and retrospective cohort studies using electronic data sets (aHR: 0.63; 95% CI: 0.51–0.78). However, this beneficial effect did not reach statistical significance for noncirrhotic patients (aHR: 0.83, 95% CI: 0.51–1.35) and retrospective/prospective cohort studies using clinical records (aHR: 0.97; 95% CI: 0.80–1.18).
DISCUSSION:
TDF was associated with a lower HCC risk compared with ETV among patients with CHB, particularly cirrhotic patients. Further prospective large-scale studies with longer follow-up periods were required to identify specific subgroups that will benefit most from TDF. |
Persistent Identifier | http://hdl.handle.net/10722/289384 |
ISSN | 2023 Impact Factor: 3.0 2023 SCImago Journal Rankings: 1.413 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KS | - |
dc.contributor.author | Mak, LY | - |
dc.contributor.author | Liu, SH | - |
dc.contributor.author | Cheng, HM | - |
dc.contributor.author | Seto, WK | - |
dc.contributor.author | Yuen, MF | - |
dc.contributor.author | Lai, CL | - |
dc.date.accessioned | 2020-10-22T08:11:53Z | - |
dc.date.available | 2020-10-22T08:11:53Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Clinical and Translational Gastroenterology, 2020, v. 11 n. 10, p. article no. e00236 | - |
dc.identifier.issn | 2155-384X | - |
dc.identifier.uri | http://hdl.handle.net/10722/289384 | - |
dc.description.abstract | INTRODUCTION: Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are recommended as first-line therapies for chronic hepatitis B (CHB) infection. Although both drugs reduce hepatocellular carcinoma (HCC) risk, their comparative effectiveness remains controversial. We aimed to determine whether TDF is superior to ETV in preventing HCC. METHODS: PubMed, Embase, and Cochrane Library from inception until June 9, 2020, were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Key terms included entecavir, tenofovir, and hepatocellular carcinoma. The adjusted hazard ratios (HRs) were pooled using a random effects model. Heterogeneity among studies was assessed by the Cochran Q test and I2. RESULTS: Thirteen observational studies (4 of which were conference abstracts) were included with 85,008 patients with CHB (ETV: 56,346; TDF: 28,662). TDF was associated with a lower HCC risk (adjusted HR [aHR]: 0.81; 95% confidence interval [CI]: 0.67–0.99). This beneficial effect was present in cirrhotic patients (aHR: 0.73; 95% CI: 0.62–0.85) and retrospective cohort studies using electronic data sets (aHR: 0.63; 95% CI: 0.51–0.78). However, this beneficial effect did not reach statistical significance for noncirrhotic patients (aHR: 0.83, 95% CI: 0.51–1.35) and retrospective/prospective cohort studies using clinical records (aHR: 0.97; 95% CI: 0.80–1.18). DISCUSSION: TDF was associated with a lower HCC risk compared with ETV among patients with CHB, particularly cirrhotic patients. Further prospective large-scale studies with longer follow-up periods were required to identify specific subgroups that will benefit most from TDF. | - |
dc.language | eng | - |
dc.publisher | Nature Publishing Group: Open Access Journals - Option A. The Journal's web site is located at http://www.nature.com/ctg/index.html | - |
dc.relation.ispartof | Clinical and Translational Gastroenterology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Hepatitis B E Antigen | - |
dc.subject | Entecavir | - |
dc.subject | Telbivudine | - |
dc.title | Entecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis | - |
dc.type | Article | - |
dc.identifier.email | Cheung, KS: cks634@hku.hk | - |
dc.identifier.email | Mak, LY: lungyi@hku.hk | - |
dc.identifier.email | Liu, SH: drkliu@hku.hk | - |
dc.identifier.email | Cheng, HM: hmcheng@hku.hk | - |
dc.identifier.email | Seto, WK: wkseto@hku.hk | - |
dc.identifier.email | Yuen, MF: mfyuen@hku.hk | - |
dc.identifier.email | Lai, CL: hrmelcl@hkucc.hku.hk | - |
dc.identifier.authority | Cheung, KS=rp02532 | - |
dc.identifier.authority | Mak, LY=rp02668 | - |
dc.identifier.authority | Seto, WK=rp01659 | - |
dc.identifier.authority | Yuen, MF=rp00479 | - |
dc.identifier.authority | Lai, CL=rp00314 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.14309/ctg.0000000000000236 | - |
dc.identifier.pmid | 33031195 | - |
dc.identifier.pmcid | PMC7544163 | - |
dc.identifier.scopus | eid_2-s2.0-85092682716 | - |
dc.identifier.hkuros | 316450 | - |
dc.identifier.volume | 11 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | article no. e00236 | - |
dc.identifier.epage | article no. e00236 | - |
dc.identifier.isi | WOS:000681351900007 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 2155-384X | - |