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Comparative Meta-Analysis of Tenofovir Disoproxil Fumarate versus Emtricitabine and Tenofovir Disoproxil Fumarate as Treatments for Patients with Chronic Hepatitis B.

Cui G, Xu X, Diao H - Sci Rep (2015)

Bottom Line: Tenofovir disoproxil fumarate (TDF) monotherapy has proven superior antiviral efficacy in chronic hepatitis B (CHB) patients; however, whether the combination of TDF and emtricitabine (FTC) exerts a significant advantage remains controversial.A meta-analysis was performed to comprehensively compare the therapeutic effects of FTC/TDF combination with TDF alone in CHB patients.In patients with nucleos(t)ide treatment history, no differences were noted between the two treatment groups after 12, 24, 48 and 96 weeks.

View Article: PubMed Central - PubMed

Affiliation: 1] State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China [2] Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.

ABSTRACT
Tenofovir disoproxil fumarate (TDF) monotherapy has proven superior antiviral efficacy in chronic hepatitis B (CHB) patients; however, whether the combination of TDF and emtricitabine (FTC) exerts a significant advantage remains controversial. A meta-analysis was performed to comprehensively compare the therapeutic effects of FTC/TDF combination with TDF alone in CHB patients. Five studies involving 614 patients were identified, and subgroup analysis was performed based on the nucleos(t)ide treatment history. Our results revealed that in patients with nucleos(t)ide-naïve treatment, there were no significant differences between the treatment groups with TDF alone and FTC/TDF combination after 12 and 24 weeks; however, the FTC/TDF combination showed better viral suppression efficacy versus TDF alone after 48 (OR = 2.16, 95% CI = 1.06-4.41, P = 0.03), 96 (OR = 2.76, 95% CI = 1.29-5.92, P = 0.009) and 192 weeks (OR = 2.60, 95% CI = 1.21-5.56, P = 0.01). In patients with nucleos(t)ide treatment history, no differences were noted between the two treatment groups after 12, 24, 48 and 96 weeks. Our results indicated that FTC/TDF combination showed better viral suppression efficacy versus TDF alone in CHB patients with nucleos(t)ide-naïve treatment, while both treatments provided similar viral suppression efficacy in CHB patients with nucleos(t)ide treatment history.

No MeSH data available.


Related in: MedlinePlus

Forest plot displaying the primary outcomes of viral suppression efficacy for CHB patients at different time points after treatments with TDF alone and FTC/TDF combination, respectively.Forest plot showed viral suppression efficacy for CHB patients with nucleos(t)ide-(or naïve) treatment history after (a) 12 weeks, (b) 24 weeks, (c) 48 weeks, (d) 96 weeks and (e) 192 weeks of treatments with TDF alone and FTC/TDF combination, respectively.
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f2: Forest plot displaying the primary outcomes of viral suppression efficacy for CHB patients at different time points after treatments with TDF alone and FTC/TDF combination, respectively.Forest plot showed viral suppression efficacy for CHB patients with nucleos(t)ide-(or naïve) treatment history after (a) 12 weeks, (b) 24 weeks, (c) 48 weeks, (d) 96 weeks and (e) 192 weeks of treatments with TDF alone and FTC/TDF combination, respectively.

Mentions: The forest plot in Fig. 2 showed the results of viral suppression efficacy for CHB patients after treatment with TDF alone or with FTC/TDF combination. The forest plots showed that there was no statistically significant heterogeneity among the studies in each subgroup; therefore, the fixed effect model was adopted in the analysis. The total analysis of the five studies for comparison of TDF alone and FTC/TDF combination showed no significant differences after 12 weeks (Fig. 2a, OR = 1.06, 95% CI = 0.74–1.51, P = 0.75, I2 = 5%) and 24 weeks (Fig. 2b, OR = 1.10, 95% CI = 0.77–1.57, P = 0.61, I2 = 0%), but an obvious difference was observed after 48 weeks (Fig. 2c, OR = 1.54, 95% CI = 1.05–2.25, P = 0.03, I2 = 0%). Notably, the total analysis showed statistically significant heterogeneity and no obvious difference between the two treatment groups after 96 weeks (Fig. 2d, OR = 1.46, 95% CI = 0.88–2.40, P = 0.14, I2 = 69%), but an obvious difference between the two treatment groups after 192 weeks (Fig. 2e, OR = 2.60, 95% CI = 1.21–5.56, P = 0.01). We performed the subgroup analysis to clarify the ambiguity in these results.


Comparative Meta-Analysis of Tenofovir Disoproxil Fumarate versus Emtricitabine and Tenofovir Disoproxil Fumarate as Treatments for Patients with Chronic Hepatitis B.

Cui G, Xu X, Diao H - Sci Rep (2015)

Forest plot displaying the primary outcomes of viral suppression efficacy for CHB patients at different time points after treatments with TDF alone and FTC/TDF combination, respectively.Forest plot showed viral suppression efficacy for CHB patients with nucleos(t)ide-(or naïve) treatment history after (a) 12 weeks, (b) 24 weeks, (c) 48 weeks, (d) 96 weeks and (e) 192 weeks of treatments with TDF alone and FTC/TDF combination, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499796&req=5

f2: Forest plot displaying the primary outcomes of viral suppression efficacy for CHB patients at different time points after treatments with TDF alone and FTC/TDF combination, respectively.Forest plot showed viral suppression efficacy for CHB patients with nucleos(t)ide-(or naïve) treatment history after (a) 12 weeks, (b) 24 weeks, (c) 48 weeks, (d) 96 weeks and (e) 192 weeks of treatments with TDF alone and FTC/TDF combination, respectively.
Mentions: The forest plot in Fig. 2 showed the results of viral suppression efficacy for CHB patients after treatment with TDF alone or with FTC/TDF combination. The forest plots showed that there was no statistically significant heterogeneity among the studies in each subgroup; therefore, the fixed effect model was adopted in the analysis. The total analysis of the five studies for comparison of TDF alone and FTC/TDF combination showed no significant differences after 12 weeks (Fig. 2a, OR = 1.06, 95% CI = 0.74–1.51, P = 0.75, I2 = 5%) and 24 weeks (Fig. 2b, OR = 1.10, 95% CI = 0.77–1.57, P = 0.61, I2 = 0%), but an obvious difference was observed after 48 weeks (Fig. 2c, OR = 1.54, 95% CI = 1.05–2.25, P = 0.03, I2 = 0%). Notably, the total analysis showed statistically significant heterogeneity and no obvious difference between the two treatment groups after 96 weeks (Fig. 2d, OR = 1.46, 95% CI = 0.88–2.40, P = 0.14, I2 = 69%), but an obvious difference between the two treatment groups after 192 weeks (Fig. 2e, OR = 2.60, 95% CI = 1.21–5.56, P = 0.01). We performed the subgroup analysis to clarify the ambiguity in these results.

Bottom Line: Tenofovir disoproxil fumarate (TDF) monotherapy has proven superior antiviral efficacy in chronic hepatitis B (CHB) patients; however, whether the combination of TDF and emtricitabine (FTC) exerts a significant advantage remains controversial.A meta-analysis was performed to comprehensively compare the therapeutic effects of FTC/TDF combination with TDF alone in CHB patients.In patients with nucleos(t)ide treatment history, no differences were noted between the two treatment groups after 12, 24, 48 and 96 weeks.

View Article: PubMed Central - PubMed

Affiliation: 1] State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China [2] Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.

ABSTRACT
Tenofovir disoproxil fumarate (TDF) monotherapy has proven superior antiviral efficacy in chronic hepatitis B (CHB) patients; however, whether the combination of TDF and emtricitabine (FTC) exerts a significant advantage remains controversial. A meta-analysis was performed to comprehensively compare the therapeutic effects of FTC/TDF combination with TDF alone in CHB patients. Five studies involving 614 patients were identified, and subgroup analysis was performed based on the nucleos(t)ide treatment history. Our results revealed that in patients with nucleos(t)ide-naïve treatment, there were no significant differences between the treatment groups with TDF alone and FTC/TDF combination after 12 and 24 weeks; however, the FTC/TDF combination showed better viral suppression efficacy versus TDF alone after 48 (OR = 2.16, 95% CI = 1.06-4.41, P = 0.03), 96 (OR = 2.76, 95% CI = 1.29-5.92, P = 0.009) and 192 weeks (OR = 2.60, 95% CI = 1.21-5.56, P = 0.01). In patients with nucleos(t)ide treatment history, no differences were noted between the two treatment groups after 12, 24, 48 and 96 weeks. Our results indicated that FTC/TDF combination showed better viral suppression efficacy versus TDF alone in CHB patients with nucleos(t)ide-naïve treatment, while both treatments provided similar viral suppression efficacy in CHB patients with nucleos(t)ide treatment history.

No MeSH data available.


Related in: MedlinePlus