Efficacy of entecavir versus tenofovir in preventing hepatocellular carcinoma in patients with chronic hepatitis B with maintained virologic response
| Autor: | Joon Hyeok Lee, Seon Yeong Baek, Kyunga Kim, Seung Woon Paik, Jeong Hoon Lee, Dong Hyun Sinn, Kwang Cheol Koh, Ji Eun Na, Moon Seok Choi, Young Han Paik, Jung Hwan Yoon, Geum-Youn Gwak, Wonseok Kang, Hee Joon Jang, Yoon Jun Kim |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Hepatitis B virus Cirrhosis Carcinoma Hepatocellular Guanine Tenofovir Subgroup analysis medicine.disease_cause Gastroenterology Antiviral Agents Hepatitis B Chronic Virology Internal medicine medicine Humans Retrospective Studies Hepatology business.industry Liver Neoplasms Entecavir medicine.disease digestive system diseases Infectious Diseases Treatment Outcome Pharmaceutical Preparations Hepatocellular carcinoma Virologic response Cohort business medicine.drug |
| Zdroj: | Journal of viral hepatitisREFERENCES. 28(10) |
| ISSN: | 1365-2893 |
| Popis: | Background & aims Several studies suggested that efficacy of tenofovir in reducing the risk of the development of hepatocellular carcinoma (HCC) might be better than that of entecavir. It remains unknown whether a change in therapy can further reduce the risk of HCC in patients receiving entecavir therapy and achieved goal of antiviral therapy, a maintained undetectable hepatitis B virus (HBV) DNA level in the serum. Methods A total of 1,336 treatment-naive chronic HBV mono-infected adult patients, who started entecavir or tenofovir treatment and achieved a maintained virologic response during follow-up were analyzed. Results During a median 4.4 years of follow-up (range, 1.0-7.4 years) after achieving virologic response, 99 patients developed HCC. The 5-year cumulative HCC incidence rate was 7.3% and 6.3% for the entecavir and tenofovir groups, respectively, with similar risk of HCC between the two groups (adjusted HR, 0.82; 95% CI, 0.52-1.29; P = 0.3). The risk of HCC was similar in the propensity score-matched cohort (HR, 1.02; 95% CI, 0.68-1.52; P = 0.94) and inverse probability treatment weighting analysis (HR, 1.11; 95% CI, 0.74-1.66; P = 0.62). In the subgroup analysis, HCC risk was similar between the two drugs in both patients with and without cirrhosis. Discussion In patients showing maintained virologic response, no difference in the risk of HCC between entecavir and tenofovir was observed. This indicate entecavir might be as effective as tenofovir in the prevention of HCC among those patients, and suggest that a change in therapy in anticipation of further reducing the risk of HCC might not be necessary for patients receiving entecavir and showing virologic response. |
| Databáze: | OpenAIRE |
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