恩替卡韦为慢性乙型肝炎的联合疗法：荟萃分析。

StephenW

Medicine (Baltimore). 2018 Dec;97(51):e13596. doi: 10.1097/MD.0000000000013596.
Entecavir-based combination therapies for chronic hepatitis B: A meta-analysis.
Luo A1, Jiang X, Ren H.
Author information

1
    Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, PR China.

Abstract
BACKGROUND:

Currently, there is no consensus on the efficacy and safety of the entecavir (ETV) monotherapy versus the ETV-based combination therapy for chronic hepatitis B.
METHODS:

A comprehensive literature search was performed on the comparison of ETV-based combination therapy and monotherapy for chronical hepatitis B (CHB) patients in the PubMed, Embase, Web of Science, the Cochrane Libraries, and the Chinese BioMedical Literature Database. Both dichotomous and continuous variables were extracted, and pooled outcomes were expressed as odds ratio (OR) or mean difference (MD).
RESULTS:

We included randomized clinical trials (RCTs) and cohorts involving Group A: nucleos(t)ide-naive patients (four RCTs, n = 719 patients), Group B: nucleos(t)ide-resistant patients (four cohorts, n = 196 patients), and Group C: entecavir-treated patients with undetectable hepatitis B virus DNA (two RCTs and two cohorts, n = 297). Group A. ETV monotherapy was better for rates of undetectable HBV DNA, while the rates of the HBV DNA levels at the end of treatment, HBeAg Loss, ALT normalization were similar between the two groups [MD, -0.85 (95% CI, -0.173-0.03); OR, 0.92 (95% CI, 0.24-3.56); OR, 1.31 (95% CI, 0.17-9.82)]; Group B. ETV monotherapy was better for rates of undetectable HBV DNA, while the rates of the HBV DNA levels at the end of treatment, HBeAg Loss, ALT normalization were similar; Group C. The ETV-based combination therapy was better for the rate of HBV DNA relapse.
CONCLUSION:

Based on the current data, ETV-based combination therapy seemed to be no better than ETV monotherapy. Further studies are needed to verify this conclusion.

PMID:
    30572464
DOI:
    10.1097/MD.0000000000013596

StephenW

医学（巴尔的摩）。 2018年12月; 97（51）：e13596。 doi：10.1097 / MD.0000000000013596。
恩替卡韦为慢性乙型肝炎的联合疗法：荟萃分析。
罗A1，江X，任H.
作者信息

1
    重庆医科大学附属第二医院感染性疾病研究所传染病分子生物学教育部重点实验室，重庆，中国。

抽象
背景：

目前，对于恩替卡韦（ETV）单药治疗与基于ETV的慢性乙型肝炎联合治疗的疗效和安全性尚未达成共识。
方法：

在PubMed，Embase，Web of Science，Cochrane图书馆和中国生物医学文献数据库中对基于ETV的联合治疗和慢性乙型肝炎（CHB）患者单药治疗的比较进行了全面的文献检索。提取二分类和连续变量，并将汇总结果表示为优势比（OR）或平均差（MD）。
结果：

我们纳入了随机临床试验（RCT）和涉及A组的队列：核心（t）认知患者（4项RCT，n = 719名患者），B组：核苷（T）抗体患者（4组，n = 196）患者）和C组：恩替卡韦治疗的患者，检测不到乙型肝炎病毒DNA（两个RCT和两个队列，n = 297）。 A组ETV单药治疗对HBV DNA检测不到率较好，而治疗结束时HBV DNA水平，HBeAg消失，ALT正常化率在两组间相似[MD，-0.85（95％CI， - 0.173-0.03）;或，0.92（95％CI，0.24-3.56）;或，1.31（95％CI，0.17-9.82）]; B组ETV单药治疗对HBV DNA检测不到率较高，而治疗结束时HBV DNA水平，HBeAg丢失，ALT正常化率相似; C组。基于ETV的联合治疗对HBV DNA复发率更好。
结论：

根据目前的数据，基于ETV的联合治疗似乎并不比ETV单药治疗更好。需要进一步的研究来验证这一结论。

结论：
    30572464
DOI：
    10.1097 / MD.0000000000013596