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Article: Entecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis

TitleEntecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis
Authors
KeywordsHepatitis B E Antigen
Entecavir
Telbivudine
Issue Date2020
PublisherNature 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?
AbstractINTRODUCTION: 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 Identifierhttp://hdl.handle.net/10722/289384
ISSN
2021 Impact Factor: 4.396
2020 SCImago Journal Rankings: 1.673
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCheung, KS-
dc.contributor.authorMak, LY-
dc.contributor.authorLiu, SH-
dc.contributor.authorCheng, HM-
dc.contributor.authorSeto, WK-
dc.contributor.authorYuen, MF-
dc.contributor.authorLai, CL-
dc.date.accessioned2020-10-22T08:11:53Z-
dc.date.available2020-10-22T08:11:53Z-
dc.date.issued2020-
dc.identifier.citationClinical and Translational Gastroenterology, 2020, v. 11 n. 10, p. article no. e00236-
dc.identifier.issn2155-384X-
dc.identifier.urihttp://hdl.handle.net/10722/289384-
dc.description.abstractINTRODUCTION: 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.languageeng-
dc.publisherNature Publishing Group: Open Access Journals - Option A. The Journal's web site is located at http://www.nature.com/ctg/index.html-
dc.relation.ispartofClinical and Translational Gastroenterology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHepatitis B E Antigen-
dc.subjectEntecavir-
dc.subjectTelbivudine-
dc.titleEntecavir vs Tenofovir in Hepatocellular Carcinoma Prevention in Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis-
dc.typeArticle-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailMak, LY: lungyi@hku.hk-
dc.identifier.emailLiu, SH: drkliu@hku.hk-
dc.identifier.emailCheng, HM: hmcheng@hku.hk-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authorityMak, LY=rp02668-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityYuen, MF=rp00479-
dc.identifier.authorityLai, CL=rp00314-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.14309/ctg.0000000000000236-
dc.identifier.pmid33031195-
dc.identifier.pmcidPMC7544163-
dc.identifier.scopuseid_2-s2.0-85092682716-
dc.identifier.hkuros316450-
dc.identifier.volume11-
dc.identifier.issue10-
dc.identifier.spagearticle no. e00236-
dc.identifier.epagearticle no. e00236-
dc.identifier.isiWOS:000681351900007-
dc.publisher.placeUnited States-
dc.identifier.issnl2155-384X-

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