替诺福韦和恩替卡韦治疗慢性乙型肝炎和HBV相关肝硬化的疗

StephenW

Int Immunopharmacol. 2016 Dec 1;42:168-175. doi: 10.1016/j.intimp.2016.11.022. [Epub ahead of print]
The efficacy and safety comparison between tenofovir and entecavir in treatment of chronic hepatitis B and HBV related cirrhosis: A systematic review and Meta-analysis.Han Y1, Zeng A1, Liao H1, Liu Y1, Chen Y1, Ding H2.
Author information

• 1Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated with Capital Medical University, China.
• 2Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated with Capital Medical University, China. Electronic address: [email protected].
  

AbstractBACKGROUND: The purpose of this study was to assess the efficacy and safety between tenofovir and entecavir in the treatment of CHB and HBV related cirrhosis through Meta-analysis. Methods The electronic databases of PubMed, the Cochrane Library, Nature, CNKI and WanFang data were searched. The key words were: ("tenofovir", "entecavir") and ("Chronic Hepatitis B" or "CHB") and "Liver cirrhosis". Heterogeneity and report bias were analyzed.
RESULTS: There was significant difference of ALT norm level in the short-term period of 3months (RR=1.43, 95%CI: 1.06-1.94, P<0.017) and 6months (RR=0.89, 95%CI: 0.81-0.97, P<0.017), and significant difference of undetectable HBV-DNA only in 3months follow-up period (RR=1.59, 95%CI: 1.04-2.42, P<0.017) between TDF and ETV, but no significant difference in the long-term period. There is significant difference between TDF and ETV in eGFR level (RR=1.601, 95%CI: 1.035-2.478, P=0.0034) and hypophosphatemia incidence (RR=4.008, 95%CI: 1.485-10.820, P=0.006).
CONCLUSION: TDF has a better efficacy than ETV in 3months treatment duration, but intriguingly, TDF might not better than ETV during the 6months treatment period in the viral suppression and liver function improvement. There's no significant difference between TDF and ETV in the long-term treatment duration and in the treatment of HBV related liver cirrhosis. Both TDF and ETV could influence renal function but patients under TDF therapy may have more risk to suffer from renal damage and hypophosphatemia.

Copyright © 2016 Elsevier B.V. All rights reserved.

KEYWORDS: CHB; Chronic hepatitis B; Efficacy; Entecavir; HBV; Safety; Tenofovir

PMID:27915131DOI:10.1016/j.intimp.2016.11.022

StephenW

Int Immunopharmacol。 2016 Dec 1; 42：168-175。 Doi：10.1016 / j.intimp.2016.11.022。 [打印前的电子版]
替诺福韦和恩替卡韦治疗慢性乙型肝炎和HBV相关肝硬化的疗效和安全性比较：系统综述和Meta分析。
Han Y1，Zeng A1，Liao H1，Liu Y1，Chen Y1，Ding H2。
作者信息

北京首都医科​​大学附属北京友安医院消化内科，肝病学系。
北京首都医科​​大学附属北京友安医院消化内科及肝脏病学教研室。电子地址：[email protected]。

抽象
背景：

本研究的目的是评估替诺福韦和恩替卡韦通过Meta分析治疗CHB和HBV相关肝硬化的疗效和安全性。方法对PubMed，Cochrane图书馆，自然，CNKI和万方数据库的电子数据库进行搜索。关键词是（“替诺福韦”，“恩替卡韦”）和（“慢性乙型肝炎”或“CHB”）和“肝硬化”。分析了异质性和报告偏差。
结果：

在短期3个月（RR = 1.43,95％CI：1.06-1.94，P <0.017）和6个月（RR = 0.89,95％CI 0.81-0.97,0.017）的ALT范围水平有显着差异，和在3个月随访期（RR = 1.59,95％CI：1.04-2.42，P <0.017）的不可检测的HBV-DNA在TDF和ETV之间的显着差异，但在长期期间没有显着差异有显着性差异（RR = 1.601,95％CI：1.035-2.478，P = 0.0034）和低磷血症发生率（RR = 4.008; 95％CI：1.485-10.820，P = 0.006）的TDF和ETV之间。
结论：

TDF在3个月的治疗持续时间内具有比ETV更好的功效，但有趣的是，在病毒抑制和肝功能改善中，在6个月的治疗期间，TDF可能不优于ETV。在长期治疗持续时间和在HBV相关肝硬化的治疗中，TDF和ETV之间没有显着差异。 TDF和ETV都可以影响肾脏功能，但是TDF治疗下的患者可能具有更多的遭受肾损伤和低磷血症的风险。

版权所有©2016 Elsevier B.V.保留所有权利。
关键词：

CHB;慢性乙型肝炎;功效;恩替卡韦HBV;安全;替诺福韦

PMID：
27915131
DOI：
10.1016 / j.intimp.2016.11.022