Open AccessComparative efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A systematic review and meta-analysis
Author(s) -
Mao-Bing Chen,
Hua Wang,
Qi-Han Zheng,
Xuwen Zheng,
Jin-nuo Fan,
Yuanhua Ding,
Jingyang Niu
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0224773
Subject(s) - entecavir , medicine , hbeag , tenofovir , meta analysis , cochrane library , chronic hepatitis , gastroenterology , hepatitis b , hepatitis b virus , virology , hbsag , lamivudine , virus , human immunodeficiency virus (hiv)
Objective To compare the efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B. Methods The Web of Science, PubMed, Cochrane Library, EMBASE, Clinical Trials and China National Knowledge Infrastructure(CNKI) databases were electronically searched to collect randomized controlled trials (RCTs) regarding the comparison between tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B (CHB) since the date of database inception to July 2019. Two researchers independently screened and evaluated the obtained studies and extracted the outcome indexes. RevMan 5.3 software was used for the meta-analysis. Results Early on, tenofovir had a greater ability to inhibit the hepatitis B virus, I 2 = 0% [RR = 1.08, 95% CI (1.03, 1.13), P <0.01] (96 weeks). Entecavir can normalize the ALT levels earlier, I 2 = 0% [RR = 0.87, 95% CI (0.77, 0.98), P = 0.02] (48 weeks). However, there was no statistically significant difference between TDF and ETV at 144 weeks. Tenofovir was as effective as entecavir in terms of HBeAg clearance and HBeAg seroconversion, I 2 = 0% [RR = 1.05, 95% CI (0.68, 1.62), P = 0.82]; I 2 = 69% [RR = 0.93, 95% CI (0.54, 1.61), P = 0.80]. The difference in the incidence of elevated creatine kinase levels was not statistically significant I 2 = 0% [RR = 0.66, 95% CI (0.27, 1.60), P = 0.35]. Conclusions Tenofovir and entecavir were equally effective in the treatment of patients with nucleos(t)ide analogue-naive chronic hepatitis B. In addition, TDF has an advantage in the incidence of hepatocellular carcinoma. Additional RCTs and a large-sample prospective cohort study should be performed.