Tenofovir Treatment Has Lower Risk of Hepatocellular Carcinoma than Entecavir Treatment in Patients with Chronic Hepatitis B: A Systematic Review and Meta-Analysis
Open Access
- 5 May 2020
- journal article
- review article
- Published by S. Karger AG in Liver Cancer
- Vol. 9 (4), 468-476
- https://doi.org/10.1159/000507253
Abstract
Purpose: Tenofovir (TDF) and entecavir (ETV) are both equally recommended as first-line treatments for patients with chronic hepatitis B (CHB). They have comparable efficacy in virologic response, but their effect on the development of hepatocellular carcinoma (HCC) in CHB is controversial. Therefore, we aimed to compare TDF and ETV evaluating the risk of HCC development in CHB patients. Methods: A systematic literature search was conducted up to November 2019 in MEDLINE/PubMed, SCOPUS, and Web of Science databases without language and time restrictions. DerSimonian and Laird random-effects models were used to estimate combined hazard ratios (HRs) and 95% CIs. Results: Seven studies containing 35,785 participants were included in this systematic review and meta-analysis. The pooled HR (95% CI) of HCC in the patients who used TDF versus patients who used ETV was 0.75 (0.56–0.96). There was no significant heterogeneity detected among the included studies results (I2 = 47.5%). There was no significant publication bias detected among the included studies (Begg’s p = 0.88 and Egger’s regression test p = 0.96). Conclusions: Evidence to date suggests that TDF treatment is associated with significantly fewer cases of HCC when compared to ETV.Keywords
This publication has 19 references indexed in Scilit:
- Mortality, liver transplantation and hepatic complications in patients with treatment‐naïve chronic hepatitis B treated with entecavir vs tenofovirJournal of Viral Hepatitis, 2018
- Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidanceJournal of Hepatology, 2018
- Long-term outcomes of hepatitis B virus-related cirrhosis treated with nucleos(t)ide analogsJournal of the Formosan Medical Association, 2017
- EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infectionJournal of Hepatology, 2017
- Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 updateHepatology International, 2015
- First‐line treatment of chronic hepatitis B with entecavir or tenofovir in ‘real‐life’ settings: from clinical trials to clinical practiceJournal of Viral Hepatitis, 2012
- Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analysesEuropean Journal of Epidemiology, 2010
- Extending DerSimonian and Laird's methodology to perform multivariate random effects meta‐analysesStatistics in Medicine, 2010
- Chronic Hepatitis BThe New England Journal of Medicine, 2002
- Meta-analysis of Observational Studies in EpidemiologyA Proposal for ReportingJAMA, 2000