恩替卡韦与替诺福韦治疗韩国初治慢性乙型肝炎预后的多中

StephenW

A multicenter study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in South Korea [url=]Seung Up Kim[/url]1,2,3,†
, [url=]Yeon Seok Seo[/url]4,†
, [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,,[url=]Correspondence information about the author Beom Kyung Kim[/url]Email the author Beom Kyung Kim
, [url=]Soo Young Park[/url]6,,[url=]Correspondence information about the author Soo Young Park[/url]Email the author Soo Young ParkEmail 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 hepatocellular carcinoma risk was not statistically different between the ETV and TDF groups.
• •The death or liver transplant risk was not statistically different between the 2 groups.
• •These results were consistently reproduced after adjusting for confounding variables.
  

Background & AimsIt is currently unclear which antiviral agent, entecavir (ETV) or tenofovir disoproxil fumarate (TDF), is superior for improving prognosis in patients with chronic hepatitis B (CHB). Here, we assessed the ability of these 2 antivirals to prevent liver-disease progression in treatment-naïve patients with CHB.


MethodsFrom 2012 to 2014, treatment-naïve patients with CHB who received ETV or TDF as a first-line antiviral agent were recruited from 4 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 not statistically 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 not statistically 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 was not statistically different between the ETV and TDF groups. Further studies are needed to validate our results.


Lay summaryIt is currently unclear which antiviral agent, entecavir or tenofovir disoproxil fumarate, is superior for improving prognosis in patients with chronic hepatitis B virus infection. In this analysis we found that there was no difference in terms of overall prognosis, including risk of hepatocellular carcinoma, death, or the need for a liver transplant, in patients receiving either antiviral.



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, HBV, HCC

StephenW

恩替卡韦与替诺福韦治疗韩国初治慢性乙型肝炎预后的多中心研究
Seung Up Kim1,2,3，†
，Yeon Seok Seo4，†
，Han Ah Lee4
，Mi Na Kim5
，Yu Rim Lee6
，Hye Won Lee 1,3
，Jun Yong Park1,2,3
，Do Young 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，低星号，'关于作者的通讯信息Beom Kyung KimEmail作者Beom Kyung Kim
，Soo Young Park6，低星号，'关于作者的通讯信息Soo Young Park电邮作者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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图形概要

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强调

•ETV和TDF组之间肝细胞癌风险无统计学差异。
•两组之间的死亡或肝移植风险无统计学差异。
•在调整混杂变量后，结果始终如一。

背景与目的

目前尚不清楚哪种抗病毒药物恩替卡韦（ETV）或替诺福韦地索普西富马酸盐（TDF）对于改善慢性乙型肝炎（CHB）患者的预后是有利的。在这里，我们评估了这两种抗病毒药物在治疗初治CHB患者中预防肝病进展的能力。
方法

从2012年到2014年，从4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HCC的累积概率和死亡或原位肝移植（OLT）。
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组的年度HCC发生率无统计学差异（1.92对1.69 / 100人年[PY]，多因素分析调整风险比[HR] 0.975 [p = 0.852]。倾向评分（PS）匹配和启动的治疗加权概率（ITPW）视图产生相似的结果模式（分别为HR 1.021 [p = 0.884]和0.998 [p = 0.988]）。 ETV和TDF组的年死亡率或OLT发生率无统计学差异（分别为0.52和0.53 / 100 PY;调整后的HR 1.202 [p = 0.451]）。 PS匹配和ITPW成员产生相似的结果模式（分别为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组之间没有统计学差异。需要进一步的研究来验证我们的结果。
放置摘要

目前尚不清楚哪种抗病毒剂恩替卡韦或替诺福韦地索普西富马酸盐对于改善慢性乙型肝炎病毒感染患者的预后是有利的。在该分析中，我们发现在接受抗病毒治疗的患者中，总体预后方面没有差异，包括肝细胞癌的风险，死亡或需要肝移植。
关键词：
恩替卡韦，替诺福韦，肝细胞癌，预后，比较，HBV，HCC