替诺福韦和恩替卡韦在韩国未接受治疗的慢性乙型肝炎患者

StephenW

Comparison of tenofovir and entecavir on the risk of hepatocellular carcinoma and mortality in treatment-naïve patients with chronic hepatitis B in Korea: a large-scale, propensity score analysis

    http://orcid.org/0000-0002-5194-5130Sung Won Lee1,2, https://orcid.org/0000-0002-5484-5864Jung Hyun Kwon1,2, Hae Lim Lee1,2, Sun Hong Yoo1,2, Hee Chul Nam1,2, Pil Soo Sung1,2, Soon Woo Nam1,2, Si Hyun Bae1,2, Jong Young Choi1,2, Seung Kew Yoon1,2, Nam Ik Han1,2, https://orcid.org/0000-0003-3255-8474Jeong Won Jang1,2

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Abstract

Objective The use of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) has led to a decrease in the incidence of hepatocellular carcinoma (HCC) and liver-related events. However, whether there is a difference between the two agents in the extent of improving such outcomes has not been clarified thus far. Therefore, we aimed to compare TDF and ETV on the risk of HCC and mortality.

Design A total of 7015 consecutive patients with CHB who were treated with TDF or ETV between February 2007 and January 2018 at the liver units of the Catholic University of Korea were screened for study eligibility and 3022 patients were finally analysed. Study end points were HCC and all-cause mortality or liver transplantation (LT) within 5 years after the initiation of antiviral therapy. Propensity score matching (PSM) and inverse probability of treatment weighting methods were used.

Results No difference was observed between TDF and ETV in the incidence rates of HCC in the entire cohort (HR 1.030; 95% CI 0.703 to 1.509, PSM model, p=0.880) and subgroups of patients with chronic hepatitis and cirrhosis. Also, no difference was observed between TDF and ETV in the incidence rates of all-cause mortality or LT in the entire cohort (HR 1.090; 95% CI 0.622 to 1.911, PSM model, p=0.763), and patients with chronic hepatitis and cirrhosis.

Conclusion This study has demonstrated the clinical outcomes in patients with CHB who received TDF or ETV treatment. There was no difference in the intermediate-term risk of HCC and mortality or LT between the two drugs.
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StephenW

替诺福韦和恩替卡韦在韩国未接受治疗的慢性乙型肝炎患者中肝细胞癌风险和死亡率的比较：大规模倾向得分分析

    http://orcid.org/0000-0002-5194-5130 Sung Won Lee1,2，https://orcid.org/0000-0002-5484-5864Jung Hyun Kwon1,2，Hae Lim Lee1,2，Sun Hong Yoo1， 2，Hee Chul Nam1,2，Pil Soo Sung1,2，Soon Woo Nam1,2，Si Hyun Bae1,2，Jong Young Choi1,2，Seung Kew Yoon1,2，Nam Ik Han1,2，https：// orcid。 org / 0000-0003-3255-8474郑元长1,2

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目的替诺福韦（TDF）和恩替卡韦（ETV）在慢性乙型肝炎（CHB）患者中的使用可降低肝细胞癌（HCC）和肝相关事件的发生率。但是，到目前为止，尚不清楚两种药物在改善此类结果的程度方面是否存在差异。因此，我们旨在比较TDF和ETV对HCC风险和死亡率的影响。

设计筛选了2007年2月至2018年1月在韩国天主教大学肝脏部门接受TDF或ETV治疗的7015例连续的CHB患者，以研究是否合格，最终分析了3022例患者。研究终点为开始抗病毒治疗后5年内的HCC和全因死亡率或肝移植（LT）。使用倾向评分匹配（PSM）和治疗加权概率的倒数。

结果在整个队列（HR 1.030； 95％CI 0.703至1.509，PSM模型，p = 0.880）以及慢性肝炎和肝硬化患者亚组中，TDF和ETV的HCC发生率没有差异。另外，在整个队列中，全因死亡率或LT的发生率在TDF和ETV之间没有观察到差异（HR 1.090； 95％CI 0.622至1.911，PSM模型，p = 0.763），以及慢性肝炎和肝硬化。

结论本研究证明了接受TDF或ETV治疗的CHB患者的临床结局。两种药物之间的HCC中期风险和死亡率或LT没有差异。
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StephenW

https://gut.bmj.com/content/gutjnl/69/7/1301.full.pdf