Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China.
J Gastroenterol Hepatol. 2020 Sep;35(9):1467-1476. doi: 10.1111/jgh.15036. Epub 2020 Mar 26.
Studies had shown that tenofovir (TDF) and entecavir (ETV) are widely used as the first-line therapy to inhibit hepatitis B virus replication, which can reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it was unclear which nucleos(t)ide analogue was most effective. Therefore, we performed a meta-analysis and a systematic review to compare the incidence of HCC in CHB patients who are either on TDF or ETV.
For this study, the following databases were searched for clinical trials published from its inception until November 2019: PubMed, Web of Science, MEDLINE, Embase, and Cochrane Library.
A total of 11 eligible studies were selected, including 70 864 patients. The meta-analysis showed that TDF was superior to ETV with regard to the incidence of HCC, the incidence of death or transplantation, and virologic response. There were no significant differences in terms of biochemical response and loss of seroconversion response among the entire cohort.
The conclusion was that CHB patients treated with TDF had a reduced incidence of HCC compared with patients treated with ETV.
研究表明，替诺福韦（TDF）和恩替卡韦（ETV）被广泛用作抑制乙型肝炎病毒复制的一线治疗药物，可降低慢性乙型肝炎（CHB）患者发生肝细胞癌（HCC）的风险，但哪种核苷（酸）类似物最有效尚不清楚。因此，我们进行了一项荟萃分析和系统评价，以比较接受 TDF 或 ETV 治疗的 CHB 患者 HCC 的发生率。
本研究检索了从成立到 2019 年 11 月发表的临床试验的以下数据库：PubMed、Web of Science、MEDLINE、Embase 和 Cochrane Library。
共纳入 11 项符合条件的研究，包括 70864 例患者。荟萃分析显示，TDF 在 HCC 发生率、死亡或移植发生率以及病毒学应答方面优于 ETV。在整个队列中，生化应答和血清转换应答丧失方面无显著差异。
与接受 ETV 治疗的患者相比，接受 TDF 治疗的 CHB 患者 HCC 发生率降低。
