Tenofovir alafenamide versus entecavir in treating patients with chronic hepatitis B: A meta-analysis

Luo, Jian-Xing; Chen, Guo; Hu, Xiao-Yu; Yu, Chang

doi:10.1016/j.gastrohep.2024.502276

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Abstract

Background

The superiority between TAF and ETV remains unclear. Which is the best choice for patients with CHB? Thus, this meta-analysis aimed to evaluate the efficacy and safety of TAF and ETV for patients with CHB.

Methods

MEDLINE/PubMed, Cochrane Library, EMBASE, Web of Science and CNKI were searched for eligible studies from inception to January 2024 and a meta-analysis was done.

Results

24 trials with a total of 6753 subjects were screened. TAF significantly improved 12- and 24-week complete virological response (CVR), 12-week biochemical response (BR) and 24-week HBeAg loss, but could not improve 48- and 96-week CVR, 24-, 48- and 96-week BR, 96-week HBeAg loss, adverse events, 48-week HBsAg decline and loss, 12-, 24- and 48-week HBeAg seroconversion, 96-week HCC incidence compared to ETV. Subgroup analysis was conducted according to race, research type and switching. Different results were obtained from different subgroups.

Conclusions

TAF was superior to ETV at 12- and 24-week CVR, 12-week BR and 24-week HBeAg loss. Race and switching might affect the efficacy of TAF and ETV.

Keywords:

Tenofovir alafenamide

Entecavir

Chronic hepatitis B

Efficacy

Adverse events

Resumen

Antecedentes

Se desconocen las ventajas entre tenofovir alafenamida (TAF) y entecavir (ETV) ¿Cuál es la mejor opción para los pacientes con hepatitis B crónica? Este metaanálisis tiene como objetivo evaluar la eficacia y la seguridad de TAF y ETV en los pacientes con hepatitis B crónica.

Método

Buscar estudios elegibles desde el principio hasta enero de 2024 en: Medline/Pubmed, Biblioteca Cochrane, Embase, Web of Science y CNKI, y realizar un metaanálisis.

Resultados

Se seleccionaron 24 ensayos con un total de 6.753 sujetos. El TAF mejoró significativamente la respuesta virológica completa (CVR) a las 12 y 24 semanas, la respuesta bioquímica (BR) a las 12 semanas y la pérdida de HBeAg a las 24 semanas, pero no mejoró la CVR a las 48 y 96 semanas, la BR a las 24, 48 y 98 semanas, la pérdida de HBeAg a las 96 semanas, los eventos adversos, la disminución y la pérdida de HBeAg a las 48 semanas, la seroconversión de HBeAg a las 12, 24 y 48 semanas, la incidencia de HCC a las 96 semanas, en comparación con ETV. Análisis de subgrupos por raza, tipo de estudio y conversión. Diferentes subgrupos obtuvieron diferentes resultados.

Conclusión

TAF fue mejor que ETV cuando se perdió HBeAg a las 12 y 24 semanas CVR, 12 y 24 semanas BR. La raza y la conversión pueden afectar la eficacia de TAF y ETV.

Palabras clave:

Tenofovir alafenamida

Entecavir

Hepatitis B crónica

Eficacia

Eventos adversos

Artículo

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