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Comparison of the on‐treatment risks for hepatocellular carcinoma between entecavir and tenofovir: A propensity score matching analysis
Author(s) -
Ha Ingyoon,
Chung Jung Wha,
Jang Eun Sun,
Jeong SookHyang,
Kim JinWook
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15031
Subject(s) - entecavir , medicine , propensity score matching , tenofovir , hepatocellular carcinoma , oncology , matching (statistics) , carcinoma , virology , hepatitis b virus , pathology , lamivudine , virus , human immunodeficiency virus (hiv)
Background and Aim Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) may reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB). However, it is not clear whether there is difference in the on‐treatment HCC risks between ETV and TDF. Methods In this retrospective cohort study, we compared the on‐treatment HCC incidence of ETV and TDF in 1340 consecutive nucleos(t)ide analog‐naïve CHB patients by propensity score (PS) matching analysis. PS was calculated by using age, sex, drinking history, diabetes, liver cirrhosis, hepatitis B e antigen positivity, hepatitis B virus DNA, hepatitis B s antigen titer, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alpha‐fetoprotein, albumin, bilirubin, prothrombin time, platelet count, and calendar year of treatment initiation as covariates. The HCC risk was assessed by Cox regression with death and liver transplantation as competing risks in the 1:1 PS‐matched cohorts ( n = 596). Results TDF had higher cumulative virologic response ( P = 0.027) whereas ETV showed higher AST and ALT normalization rates ( P = 0.005 and < 0.001, respectively) in PS‐matched cohorts. HCC risk was similar between ETV and TDF, either by PS‐matching analysis (hazard ratio [HR] for TDF over ETV = 2.06, 95% confidence interval [CI] = 0.98–4.33, P = 0.058) or inverse probability of treatment weighting analysis (HR = 1.30, 95% CI = 0.81–2.10; P = 0.276). Conclusions ETV and TDF treatment was associated with similar risk for HCC development in CHB patients.