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Comparison of efficacy and safety of tenofovir and entecavir in chronic hepatitis B virus infection: a systematic review and meta-analysis.

Ke W, Liu L, Zhang C, Ye X, Gao Y, Zhou S, Yang Y - PLoS ONE (2014)

Bottom Line: Multiple studies have compared efficacy and safety of these two agents, but yielded inconsistent results.Additionally, no significant distinction in short term safety was found for CHB patients.TDF and ETV are similarly effective and safe in chronic HBV patients after 24 weeks and 48 weeks of anti-viral therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics and Guangdong Key Lab of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.

ABSTRACT

Objective: Tenofovir (TDF) and entecavir (ETV) are both potent antiviral agents for the treatment of chronic hepatitis B virus (HBV) infection. Multiple studies have compared efficacy and safety of these two agents, but yielded inconsistent results. Hence, we conducted a meta-analysis to discern comparative efficacy and safety.

Methods: Published data relevant to a comparison of TDF and ETV used in HBV were included. HBV DNA suppression rate, ALT normalization rate, and HBeAg seroconversion rate at 24 weeks and 48 weeks were reviewed. Drug safety profiles and resistance were also discussed.

Results: Seven articles met entry criteria. Four and six articles included data for 24 and 48-week HBV DNA suppression rates, respectively, and no significant differences for the rates between the two drugs were found in chronic HBV patients (TDF vs. ETV: relative risk [RR] = 1.10, 95% CI = 0.91-1.33 and RR = 1.07, 95% CI = 0.99-1.17 for 24 weeks and 48 weeks, respectively). For the ALT normalization rate (three studies for 24 weeks, four articles for 48 weeks) and HBeAg seroconversion rate (two and four studies for 24 weeks and 48 weeks, respectively), no difference was observed between TDF and ETV. Additionally, no significant distinction in short term safety was found for CHB patients.

Conclusions: TDF and ETV are similarly effective and safe in chronic HBV patients after 24 weeks and 48 weeks of anti-viral therapy. Nevertheless, the long-term efficacy and safety of TDF and ETV should be monitored in prolonged therapy.

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Flow diagram of selecting included studies.
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pone-0098865-g001: Flow diagram of selecting included studies.

Mentions: We identified 885 citations via electronic searches (Fig. 1). Seven were selected describing treatment of chronic HBV infection involving 844 patients (378 treated with TDF monotherapy and 466 treated with ETV monotherapy). Of these studies, two were RCTs [16]–[17], four were cohort studies [18]–[21], and one was a case-cohort study [14]. The detailed information of included studies is summarized in Table 1.


Comparison of efficacy and safety of tenofovir and entecavir in chronic hepatitis B virus infection: a systematic review and meta-analysis.

Ke W, Liu L, Zhang C, Ye X, Gao Y, Zhou S, Yang Y - PLoS ONE (2014)

Flow diagram of selecting included studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048232&req=5

pone-0098865-g001: Flow diagram of selecting included studies.
Mentions: We identified 885 citations via electronic searches (Fig. 1). Seven were selected describing treatment of chronic HBV infection involving 844 patients (378 treated with TDF monotherapy and 466 treated with ETV monotherapy). Of these studies, two were RCTs [16]–[17], four were cohort studies [18]–[21], and one was a case-cohort study [14]. The detailed information of included studies is summarized in Table 1.

Bottom Line: Multiple studies have compared efficacy and safety of these two agents, but yielded inconsistent results.Additionally, no significant distinction in short term safety was found for CHB patients.TDF and ETV are similarly effective and safe in chronic HBV patients after 24 weeks and 48 weeks of anti-viral therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics and Guangdong Key Lab of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.

ABSTRACT

Objective: Tenofovir (TDF) and entecavir (ETV) are both potent antiviral agents for the treatment of chronic hepatitis B virus (HBV) infection. Multiple studies have compared efficacy and safety of these two agents, but yielded inconsistent results. Hence, we conducted a meta-analysis to discern comparative efficacy and safety.

Methods: Published data relevant to a comparison of TDF and ETV used in HBV were included. HBV DNA suppression rate, ALT normalization rate, and HBeAg seroconversion rate at 24 weeks and 48 weeks were reviewed. Drug safety profiles and resistance were also discussed.

Results: Seven articles met entry criteria. Four and six articles included data for 24 and 48-week HBV DNA suppression rates, respectively, and no significant differences for the rates between the two drugs were found in chronic HBV patients (TDF vs. ETV: relative risk [RR] = 1.10, 95% CI = 0.91-1.33 and RR = 1.07, 95% CI = 0.99-1.17 for 24 weeks and 48 weeks, respectively). For the ALT normalization rate (three studies for 24 weeks, four articles for 48 weeks) and HBeAg seroconversion rate (two and four studies for 24 weeks and 48 weeks, respectively), no difference was observed between TDF and ETV. Additionally, no significant distinction in short term safety was found for CHB patients.

Conclusions: TDF and ETV are similarly effective and safe in chronic HBV patients after 24 weeks and 48 weeks of anti-viral therapy. Nevertheless, the long-term efficacy and safety of TDF and ETV should be monitored in prolonged therapy.

Show MeSH
Related in: MedlinePlus