恩替卡韦与替诺福韦联合治疗大韩民国治疗初治慢性乙型肝

StephenW

A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea [url=]Seung Up Kim[/url]1,2,3,a
, [url=]Yeon Seok Seo[/url]4,a
, [url=]Han Ah Lee[/url]4
, [url=]Mi Na Kim[/url]5
, [url=]Yu Rim Lee[/url]6
, [url=]Hye Won Lee[/url]1,3
, [url=]Jun Yong Park[/url]1,2,3
, [url=]Do Young Kim[/url]1,2,3
, [url=]Sang Hoon Ahn[/url]1,2,3
, [url=]Kwang-Hyub Han[/url]1,2,3
, [url=]Seong Gyu Hwang[/url]5
, [url=]Kyu Sung Rim[/url]5
, [url=]Soon Ho Um[/url]4
, [url=]Won Young Tak[/url]6
, [url=]Young Oh Kweon[/url]6
, [url=]Beom Kyung Kim[/url]1,2,3,b,,[url=]Correspondence information about the author Beom Kyung Kim[/url]Email the author Beom Kyung Kim
, [url=]Soo Young Park[/url]6,b,,[url=]Correspondence information about the author Soo Young Park[/url]Email the author Soo Young Park





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DOI: https://doi.org/10.1016/j.jhep.2019.03.028
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Highlights

• •The HCC risk was statistically not different between the ETV and TDF groups.
• •The death or liver transplant risk was statistically not different between 2 groups.
• •Such results were consistently reproduced after adjusting confounding variables.
  

AbstractBackground & aimsWhich antiviral agent between entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF) is superior in improving prognosis for chronic hepatitis B (CHB) is unclear. Here, we assessed the ability of these two antivirals to prevent liver-disease progression in treatment–naïve CHB patients.


MethodsFrom 2012 to 2014, treatment-naïve CHB patients who received ETV or TDF as a first–line antiviral agent were recruited from four academic teaching hospitals. Patients with decompensated cirrhosis or hepatocellular carcinoma (HCC) at enrollment were excluded. Cumulative probabilities of HCC and death or orthotopic liver transplant (OLT) were assessed.


ResultsIn total, 2,897 patients (1,484 and 1,413 in the ETV and TDF groups, respectively) were recruited. The annual HCC incidence was statistically not different between the ETV and TDF groups (1.92 vs. 1.69 per 100 person-years [PY], respectively; adjusted hazard ratio [HR], 0.975 [p=0.852] by multivariate analysis). Propensity score (PS)-matched and inverse probability of treatment weighting (ITPW) analyses yielded similar patterns of results (HR, 1.021 [p=0.884] and 0.998 [p=0.988], respectively). The annual incidence of death or OLT was statistically not different between the ETV and TDF groups (0.52 vs. 0.53 per 100 PY, respectively; adjusted HR, 1.202 [p=0.451]). PS-matched and ITPW analyses yielded similar patterns of results (HR, 1.248 [p=0.385] and 1.239 [p=0.360], respectively). These findings were consistently reproduced in patients with compensated cirrhosis (all p>0.05).


ConclusionsThe overall prognosis in terms of HCC and death or OLT were statistically not different between the ETV and TDF groups. Further studies are needed to validate our results.


Lay summary- Which antiviral agent between entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF) is superior in improving prognosis for chronic hepatitis B (CHB) is unclear.

- The overall prognosis in terms of HCC and death or OLT was statistically not different between the ETV and TDF groups.



Keywords:Entecavir, tenofovir, [url=https://www.journal-of-hepatology.eu/action/doSearch?searchType=quick&occurrences=all<rlSrch=true&searchScope=fullSite&searchText=hepatocellular carcinoma&code=jhepat-site]hepatocellular carcinoma[/url], prognosis, comparison

StephenW

恩替卡韦与替诺福韦联合治疗大韩民国治疗初治慢性乙型肝炎预后的多中心研究
Seung Up Kim1,2,3，a
，Yeon Seok Seo4，a
，Han Ah Lee4
，Mi Na Kim5
，Yu Rim Lee6
，Hye Won Lee 1,3
，君勇公园1,2,3
，年轻的Kim1,2,3
，Sang Hoon Ahn1,2,3
，Kwang-Hyub Han1,2,3
，Seong Gyu Hwang5
，Kyu Sung Rim5
，很快Ho Um4
，Won Young Tak6
，年轻哦，Kweon6
，Beom Kyung Kim1,2,3，b，低星号，'关于作者的通讯信息Beom Kyung KimEmail作者Beom Kyung Kim
，Soo Young Park6，b，低星号，'关于作者的通讯信息Soo Young Park电邮作者Soo Young Park
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DOI：https：//doi.org/10.1016/j.jhep.2019.03.028
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强调

    •ETV和TDF组之间的HCC风险在统计学上没有差异。
    •两组患者的死亡或肝移植风险在统计学上没有差异。
    •调整混杂变量后，这些结果始终如一。

抽象
背景和目标

恩替卡韦（ETV）与替诺福韦地索普西富马酸盐（TDF）之间哪种抗病毒药物在改善慢性乙型肝炎（CHB）预后方面具有优势尚不清楚。在这里，我们评估了这两种抗病毒药物在未接受治疗的CHB患者中预防肝病进展的能力。
方法

从2012年到2014年，从四所学术教学医院招募了接受过ETV或TDF作为一线抗病毒药物治疗的初治CHB患者。入选时失代偿期肝硬化或肝细胞癌（HCC）患者被排除在外。评估了HCC和死亡或原位肝移植（OLT）的累积概率。
结果

总共招募了2,897名患者（分别为ETV和TDF组中的1,484名和1,413名）。 ETV和TDF组之间的年度HCC发生率在统计学上没有差异（分别为1.92对1.69 / 100人年[PY];校正风险比[HR]，0.975 [p = 0.852]通过多变量分析）。倾向评分（PS） - 治疗加权（ITPW）分析的匹配和反向概率产生相似的结果模式（HR，1.021 [p = 0.884]和0.998 [p = 0.988]）。 ETV和TDF组的年死亡率或OLT在统计学上没有差异（分别为0.52对0.53 / 100 PY;调整后的HR，1.202 [p = 0.451]）。 PS匹配和ITPW分析产生相似的结果模式（HR，1.248 [p = 0.385]和1.239 [p = 0.360]）。这些发现在代偿性肝硬化患者中得到了一致的反复（均p> 0.05）。
结论

在HCC和死亡或OLT方面的总体预后在ETV和TDF组之间在统计学上没有差异。需要进一步的研究来验证我们的结果。
放置摘要

- 恩替卡韦（ETV）与替诺福韦地索普西富马酸盐（TDF）之间哪种抗病毒药物在改善慢性乙型肝炎（CHB）预后方面具有优势尚不清楚。

- 在HCC和死亡或OLT方面的总体预后在ETV和TDF组之间在统计学上没有差异。
关键词：
恩替卡韦，替诺福韦，肝细胞癌，预后，比较/