慢性乙型肝炎的核苷酸（t）类似物的不良事件：系统评价。

StephenW

J Gastroenterol. 2020 Mar 17. doi: 10.1007/s00535-020-01680-0. [Epub ahead of print]
Adverse events of nucleos(t)ide analogues for chronic hepatitis B: a systematic review.
de Fraga RS1,2, Van Vaisberg V3, Mendes LCA4, Carrilho FJ3,4, Ono SK3,4.
Author information

1
    Department of Gastroenterology, University of São Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255 ICHC, 9th floor, Office 9159, São Paulo, SP, 05403-000, Brazil. [email protected].
2
    IMED School of Medicine, Passo Fundo, RS, Brazil. [email protected].
3
    Department of Gastroenterology, University of São Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255 ICHC, 9th floor, Office 9159, São Paulo, SP, 05403-000, Brazil.
4
    Division of Clinical Gastroenterology and Hepatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, SP, Brazil.

Abstract

Nucleos(t)ide analogues (NAs) are the main drug category used in chronic hepatitis B (CHB) treatment. Despite the fact that NAs have a favourable safety profile, undesired adverse events (AEs) may occur during the treatment of CHB. Given the eminent number of patients currently receiving NAs, even a small risk of any of these toxicities can represent a major medical issue. The main objective of this review was to analyse information available on AEs associated with the use of NAs in published studies. We choose the following MesH terms for this systematic review: chronic hepatitis B, side effects and treatment. All articles published from 1 January 1990 up to 19 February 2018 in MEDLINE of PubMed, EMBASE, the Cochrane Library and LILACS databases were searched. A total of 120 articles were selected for analysis, comprising 6419 patients treated with lamivudine (LAM), 5947 with entecavir (ETV), 3566 with tenofovir disoproxil fumarate (TDF), 3096 with telbivudine (LdT), 1178 with adefovir dipivoxil (ADV) and 876 with tenofovir alafenamide (TAF). The most common AEs in all NAs assessed were abdominal pain/discomfort, nasopharyngitis/upper respiratory tract infections, fatigue, and headache. TAF displays the highest density of AEs per patient treated among NAs (1.14 AE/treated patient). In conclusion, treatment of CHB with NAs is safe, with a low incidence of AEs. Despite the general understanding TAF being safer than TDF, the number of patients treated with TAF still is too small in comparison to other NAs to consolidate an accurate safety profile. PROSPERO Registration No. CRD42018086471.
KEYWORDS:

Adverse events; Chronic hepatitis B; Nucleotide/nucleoside analogues

PMID:
    32185517
DOI:
    10.1007/s00535-020-01680-0

StephenW

J胃肠。 2020年3月17日。doi：10.1007 / s00535-020-01680-0。 [Epub提前发行]
慢性乙型肝炎的核苷酸（t）类似物的不良事件：系统评价。
de Fraga RS1,2，Van Vaisberg V3，Mendes LCA4，Carrilho FJ3,4，Ono SK3,4。
作者信息

1个
圣保罗大学医学院消化科EnéasCarvalho de Aguiar博士，邮编：05403-000，巴西，圣保罗，9159 Office 9159 Office 9楼255 [email protected]。
2
巴西，帕苏丰杜，IMED医学院。rschfraga@ gmail.com。
3
圣保罗大学医学院消化科EnéasCarvalho de Aguiar博士，地址：255 ICHC，巴西圣保罗9159号办公室9楼，邮政编码：05403-000。
4
巴西圣保罗大学圣保罗大学医学院dasClínicas医院临床胃肠病学和肝病科。

抽象

核苷类似物（NAs）是用于慢性乙型肝炎（CHB）治疗的主要药物类别。尽管NA的安全性良好，但在CHB的治疗过程中可能发生不良不良事件（AE）。鉴于目前正在接受NA的患者人数众多，即使这些毒性的风险很小，也可能代表着重大的医学问题。这篇综述的主要目的是分析已发表的研究中与使用NA相关的不良事件的可用信息。我们为系统评价选择以下MesH术语：慢性乙型肝炎，副作用和治疗。搜索了1990年1月1日至2018年2月19日在MEDLINE of PubMed，EMBASE，Cochrane Library和LILACS数据库中发表的所有文章。总共选择了120篇文章进行分析，包括6419例接受拉米夫定（LAM）治疗的患者，5947接受恩替卡韦（ETV）治疗的患者，3566接受富马酸替诺福韦酯（TDF）的患者，3096接受替比夫定（LdT）的患者，1178接受阿德福韦酯的患者1178 ）和876与Tenofovir alafenamide（TAF）。在所有评估的NA中，最常见的AE是腹痛/不适，鼻咽炎/上呼吸道感染，疲劳和头痛。在NAs中，TAF显示每位接受治疗的患者的AE密度最高（1.14 AE /接受治疗的患者）。总之，用NAs治疗CHB是安全的，AEs的发生率低。尽管人们普遍认为TAF比TDF安全，但与其他NA相比，TAF治疗的患者人数仍然太少，无法巩固准确的安全性。 PROSPERO注册号CRD42018086471。
关键字：

不良事件;慢性乙型肝炎；核苷酸/核苷类似物

PMID：
32185517
DOI：
10.1007 / s00535-020-01680-0

StephenW

https://link.springer.com/conten ... 535-020-01680-0.pdf