Comparison of the forty-eight week efficacy between telbivudine and entecavir in HBeAg-positive Asian patients with chronic hepatitis B: A meta-analysis.

BACKGROUND/AIMS: Telbivudine and entecavir are two pharmacologic agents recommended and also widely used for the treatment of chronic hepatitis B in most Asian countries. There are few conclusive results when comparing the efficacy of these two drugs for the treatment of chronic hepatitis B. The aim of this study is to evaluate, by means of meta-analysis, the short-term efficacy between the two drugs in nucleos(t)ide-naïve Asian HBeAg-positive chronic hepatitis B patients.

MATERIALS AND METHODS

We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, the Wanfang Database and CNKI (National Knowledge Infrastructure). Twelve eligible trials (1011 patients in total) were included into this study, and they were evaluated for quality and heterogeneity.

RESULTS

Meta-analysis date showed the rate of HBeAg clearance and rate of HBeAg seroconversion in the telbivudine group was higher than the entecavir group, respectively. There was no statistically significant difference however between the two groups in the rate of alanine aminotransferase normalization, or the rate of HBV DNA suppression. Although creatine kinase elevations occurred more frequently in the telbivudine group than when compared to the entecavir group, there was no statistically significant difference between the two groups in the short-term treatment duration.

CONCLUSIONS

For the short-term treatment of HBeAg-positive nucleos(t)ide-naïve Asian patients with chronic hepatitis B, telbivudine is as potent as entecavir in normalizing alanine aminotransferase and suppressing HBV DNA, and telbivudine is superior to entecavir in clearing HBeAg and developing anti-HBe. Careful monitoring is needed to avoid adverse events, as well as drug resistance during antiviral therapy with telbivudine.