Limits...
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.

Show MeSH

Related in: MedlinePlus

Forest plot for HBV DNA suppression rates 48 weeks post therapy.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4048232&req=5

pone-0098865-g003: Forest plot for HBV DNA suppression rates 48 weeks post therapy.

Mentions: For four studies evaluating patients post 24 weeks of therapy [14], [17], [20], [21], the pooled HBV DNA suppression rates were 50% (95%CI = 25%–74%) and 46% (95%CI = 24%–68%) for TDF and ETV, respectively. No significant heterogeneity existed across studies (P for heterogeneity = 0.63; I2 = 0%). In the fixed-effect model, no significantly difference was determined between TDF and ETV treatment groups in the HBV DNA suppression rate through 24 weeks of treatment (RR = 1.10, 95% CI = 0.91–1.33; Fig.2). Six studies compared HBV DNA suppression rates after 48 weeks of therapy (Fig.3), which were also similar for TDF (80%, 95%CI = 71%–90%) and ETV (76%, 95%CI 63%–88%). No significant heterogeneity was observed (P = 0.59, I2 = 0%), and no significant difference was also observed in that rate after 48 weeks treatment between the two treatment groups (RR = 1.07, 95%CI = 0.99–1.17). The statistic power for 24 and 48 weeks HBV DNA suppression rates were 92.08% and 85.03%, respectively.


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)

Forest plot for HBV DNA suppression rates 48 weeks post therapy.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0098865-g003: Forest plot for HBV DNA suppression rates 48 weeks post therapy.
Mentions: For four studies evaluating patients post 24 weeks of therapy [14], [17], [20], [21], the pooled HBV DNA suppression rates were 50% (95%CI = 25%–74%) and 46% (95%CI = 24%–68%) for TDF and ETV, respectively. No significant heterogeneity existed across studies (P for heterogeneity = 0.63; I2 = 0%). In the fixed-effect model, no significantly difference was determined between TDF and ETV treatment groups in the HBV DNA suppression rate through 24 weeks of treatment (RR = 1.10, 95% CI = 0.91–1.33; Fig.2). Six studies compared HBV DNA suppression rates after 48 weeks of therapy (Fig.3), which were also similar for TDF (80%, 95%CI = 71%–90%) and ETV (76%, 95%CI 63%–88%). No significant heterogeneity was observed (P = 0.59, I2 = 0%), and no significant difference was also observed in that rate after 48 weeks treatment between the two treatment groups (RR = 1.07, 95%CI = 0.99–1.17). The statistic power for 24 and 48 weeks HBV DNA suppression rates were 92.08% and 85.03%, respectively.

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