Chen Ling, Wang Xiwei, Zhang Qiongfang, Gong Jiaojiao, Shen Shasha, Yin Wenwei, Hu Huaidong
Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Gastroenterol Res Pract. 2016;2016:7214020. doi: 10.1155/2016/7214020. Epub 2016 Jan 11.
Background/Aims. It remains unclear whether tenofovir disoproxil fumarate- (TDF-) based combination therapy produces better outcomes than TDF monotherapy in chronic hepatitis B (CHB) patients. The aim of this study was to compare the efficacy of the two regimens by performing a meta-analysis. Methods. A comprehensive literature search was performed on the comparison of TDF-based combination therapy and monotherapy for CHB patients in the PubMed, Embase, Web of Science, and the Cochrane Libraries. Both dichotomous and continuous variables were extracted and pooled outcomes were expressed as risk ratio (RR) or standard mean difference (SMD). Results. Nine eligible studies (1089 subjects in total) were included in our analysis. The proportion of patients with undetectable HBV DNA at 24, 48, and 96 weeks were similar between the two comparable groups (62.5% versus 70.9%, P = 0.086; 78.1% versus 83.7%, P = 0.118; 86.4% versus 87.9%, P = 0.626, resp.). HBV DNA reduction, rates of ALT normalization, hepatitis B e antigen (HBeAg) loss, and HBeAg seroconversion were also similar between the two groups. Conclusions. On the current data, TDF-based combination therapy seemed to be no better than those achieved by monotherapy. Further studies are needed to verify this comparison.
背景/目的。在慢性乙型肝炎（CHB）患者中，基于替诺福韦酯富马酸盐（TDF）的联合治疗是否比TDF单药治疗产生更好的疗效仍不清楚。本研究的目的是通过进行荟萃分析比较两种治疗方案的疗效。方法。在PubMed、Embase、Web of Science和Cochrane图书馆中对基于TDF的联合治疗与CHB患者单药治疗的比较进行了全面的文献检索。提取二分变量和连续变量，汇总结果以风险比（RR）或标准化均数差（SMD）表示。结果。我们的分析纳入了9项符合条件的研究（共1089名受试者）。在两个可比组中，24周、48周和96周时HBV DNA检测不到的患者比例相似（分别为62.5%对70.9%，P = 0.086；78.1%对83.7%，P = 0.118；86.4%对87.9%，P = 0.626）。两组之间的HBV DNA降低、ALT正常化率、乙肝e抗原（HBeAg）消失和HBeAg血清学转换也相似。结论。根据目前的数据，基于TDF的联合治疗似乎并不比单药治疗效果更好。需要进一步的研究来验证这种比较。
