在核苷肾功能（T）IDE模拟治疗的患者慢性乙型肝炎：系统性

StephenW

Adv Ther. 2016 May 4. [Epub ahead of print]
Renal Function in Nucleos(t)ide Analog-Treated Patients With Chronic Hepatitis B: A Systematic Literature Review and Network Meta-Analysis.Chan HL1, Shaikh J2, Gupta S2, Hamed K3.
Author information

• 1Department of Medicine and Therapeutics and Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
• 2Novartis Healthcare Pvt. Ltd., Hyderabad, India.
• 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. [email protected].
  

AbstractINTRODUCTION: Renal safety is an important factor in selecting the most appropriate nucleos(t)ide analog (NA) treatment for patients with chronic hepatitis B (CHB). This systematic literature review and network meta-analysis aimed to assess renal function associated with telbivudine treatment compared to other NAs in patients with CHB.
METHODS: A systematic literature search via Medline, Medline In-Process, Embase, and the Cochrane library for publications of randomized controlled trials and observational studies was conducted. Network meta-analysis was performed to compare renal function with telbivudine treatment versus other NAs after 1 year of therapy.
RESULTS: Overall, 40 (six randomized controlled and 34 observational) studies were included for review. Telbivudine consistently showed an improvement in renal function as measured by an estimated glomerular filtration rate (eGFR) over various time points regardless of the method of measurement. Changes in eGFR (mL/min) from baseline and corresponding 95% credible intervals with various NAs were as follows: monotherapies (telbivudine: 7.78 [6.91, 8.65], entecavir: -1.07 [-4.80, 2.62], lamivudine: -6.08 [-13.35, 1.15], tenofovir: -9.53 [-14.31, -4.89]) and combination therapies (telbivudine + adefovir: 8.37 [-34.00, 50.34], telbivudine + tenofovir: 8.29 [-0.05, 16.64], entecavir + adefovir: 4.15 [-38.55, 46.37], telbivudine + lamivudine: 0.51 [-11.77, 12.96], and lamivudine + adefovir: -0.39 [-42.48, 41.21]). At 1 year, the change in eGFR from baseline was significantly higher with telbivudine compared to other NAs.
CONCLUSION: The systematic literature review and network meta-analysis provide evidence that telbivudine is associated with significant improvement in renal function in patients with CHB, either alone or in combination with other NAs.
FUNDING: Novartis Pharma AG.


KEYWORDS: Chronic hepatitis B; Hepatology; Infectious disease; Nucleos(t)ide analogs; Renal function; Telbivudine; eGFR

StephenW

进阶疗法。 2016年5月4日[印刷前EPUB]
在核苷肾功能（T）IDE模拟治疗的患者慢性乙型肝炎：系统性文献综述和网络荟萃分析。
陈HL1，谢赫J2，古普塔S2，哈米德K3。
作者信息

    内科及药物治疗和消化疾病，香港大学中国香港特区，中国研究所教研室。
    2Novartis医疗列兵。有限公司，海得拉巴，印度。
    3Novartis制药公司，东汉诺威，NJ，USA。 [email protected]。

抽象
介绍：

肾安全是在选择最适当的核苷（酸）IDE类似物（NA）治疗慢性乙型肝炎（CHB）的重要因素。本系统的文献综述和网络荟萃分析的目的是评估与比较，CHB患者持其他NAS替比夫定治疗相关的肾功能。
方法：

通过医学，MEDLINE正在处理的，文摘，和Cochrane图书馆的随机对照试验和观察研究的出版物系统性文献检索进行。进行网络荟萃分析治疗1年后，比较用替比夫定治疗与其他的NA肾功能。
结果：

总体而言，40（六项随机对照和34观察）被列入审查研究。夫定一致显示在肾功能的改善，无论测量的方法的通过的估计肾小球滤过率（eGFR）在不同的时间点测量。从基线相应的95％置信区间与各种的NA在表皮生长因子受体（毫升/分钟）的变化和结果如下：单一疗法（夫定：7.78 [6.91，8.65]，恩替卡韦：-1.07 [-4.80，2.62]，拉米夫定：-6.08 [ -13.35，1.15]，替诺福韦：-9.53 [-14.31，-4.89]），并联合疗法（替比夫定+阿德福韦：8.37 [-34.00，50.34]，替比夫定+替诺福韦：8.29 [-0.05，16.64]，恩替卡韦+阿德福韦： 4.15 [-38.55，46.37]，替比夫定+拉米夫定：0.51 [-11.77，12.96]，拉米夫定和阿德福韦+：-0.39 [-42.48，41.21]）。 1年，从基线eGFR的变化是替比夫定显著高于相比其他来港定居。
结论：

该系统的文献回顾和网络荟萃分析提供的证据表明，替比夫定在肾功能与显著改善相关CHB患者，无论是单独使用或与其它的NA的组合。
资金：

诺华制药公司。
关键词：

慢性乙型肝炎;肝病;传染病;核苷（酸）类似物;肾功能;替比夫定;表皮生长因子受体