Center of Integrative Medicine (HL, XW, ZY), Beijing Ditan Hospital, and Statistics Room (GW), and Institute of Infectious Diseases (HZ), Capital Medical University, Beijing, China.
Am J Med Sci. 2014 Feb;347(2):131-8. doi: 10.1097/MAJ.0b013e318286878d.
We performed a meta-analysis to compare the efficacies of entecavir and telbivudine in treatment-naive hepatitis B e-antigen (HBeAg)-positive Asian patients with chronic hepatitis B (CHB).
Randomized controlled trials (January 1, 2000 to March 30, 2012) directly comparing entecavir 0.5 mg/d and telbivudine 600 mg/d, used for a minimum of 12 weeks in nucleos(t)ide-naive Asian patients with HBeAg-positive CHB, were searched in the PubMed, Embase, OVID, Cochrane Library, CNKI, VIP and WanFang databases. Publication quality was assessed using the Jadad quality scale. The rates of viral response, biochemical response, HBeAg loss and HBeAg seroconversion were analyzed using forest plots.
Seven eligible articles (867 patients in total) were included in this meta-analysis. With regard to the rates of hepatitis B virus DNA suppression, there were no significant differences between patients treated with entecavir or telbivudine at 12 and 48 weeks, but telbivudine was superior at 24 weeks. Twelve, 24 and 48 weeks after the start of therapy, the rates of alanine aminotransferase normalization were similar between the 2 drugs, and patients treated with telbivudine had higher HBeAg loss and seroconversion rates than patients treated with entecavir.
In nucleos(t)ide-naive Asian patients with HBeAg-positive CHB, assessed 12, 24, and 48 weeks after beginning treatment, telbivudine was as potent as entecavir in viral suppression, but superior with regard to HBeAg loss and seroconversion. Telbivudine seems to be more effective and suitable for these patients.
我们进行了一项荟萃分析，比较了恩替卡韦和替比夫定在初治乙型肝炎 e 抗原（HBeAg）阳性的亚洲慢性乙型肝炎（CHB）患者中的疗效。
我们在 PubMed、Embase、OVID、Cochrane 图书馆、CNKI、VIP 和万方数据库中检索了 2000 年 1 月 1 日至 2012 年 3 月 30 日直接比较恩替卡韦 0.5mg/d 和替比夫定 600mg/d 的随机对照试验，这些药物均用于 HBeAg 阳性 CHB 的初治亚洲核苷（酸）类似物-naive 患者，治疗时间至少为 12 周。使用 Jadad 质量量表评估发表质量。使用森林图分析病毒应答率、生化应答率、HBeAg 丢失和 HBeAg 血清学转换率。
本荟萃分析共纳入 7 篇符合条件的文献（共 867 例患者）。在乙型肝炎病毒 DNA 抑制率方面，恩替卡韦和替比夫定在 12 周和 48 周时无显著差异，但替比夫定在 24 周时更优。在开始治疗后 12、24 和 48 周，两种药物的丙氨酸氨基转移酶正常化率相似，替比夫定治疗组的 HBeAg 丢失和血清学转换率高于恩替卡韦治疗组。
在 HBeAg 阳性的亚洲初治 CHB 患者中，在开始治疗后 12、24 和 48 周评估时，替比夫定在病毒抑制方面与恩替卡韦相当，但在 HBeAg 丢失和血清学转换方面更优。替比夫定似乎对这些患者更有效且更适合。
