STUDY OBJECTIVE: To compare the efficacy of nucleoside or nucleotide analog monotherapy for the treatment of chronic hepatitis virus B (HBV) with adefovir dipivoxil, entecavir, lamivudine, telbivudine, and tenofovir disoproxil fumarate. DESIGN: Mixed-treatment comparison meta-analysis of nine randomized controlled clinical trials. PATIENTS: A total of 3972 adults with a diagnosis of chronic hepatitis B. MEASUREMENTS AND MAIN RESULTS: A systematic review was conducted to search for randomized clinical trials that evaluated the efficacy of nucleoside or nucleotide analogs used as monotherapy. The evaluated outcomes were reduction of HBV DNA levels, normalization of alanine aminotransferase levels, and seroconversion of hepatitis B e antigen (HBeAg). A mixed-treatment comparison was conducted to compare the odds ratios among the treatments and to rank the therapies to determine the optimal treatment option. Tenofovir had the best results among the nucleoside or nucleotide analogs for the three evaluated efficacy outcomes in both HBeAg-positive and -negative patients. CONCLUSION: Tenofovir has the highest probability of reducing HBV DNA, normalizing alanine aminotransferase levels and inducing HBeAg seroconversion after 1 year of treatment. An efficacy comparison of therapies is an important tool to guide clinicians in selecting the optimal treatment option.
STUDY OBJECTIVE: To compare the efficacy of nucleoside or nucleotide analog monotherapy for the treatment of chronic hepatitis virus B (HBV) with adefovir dipivoxil, entecavir, lamivudine, telbivudine, and tenofovir disoproxil fumarate. DESIGN: Mixed-treatment comparison meta-analysis of nine randomized controlled clinical trials. PATIENTS: A total of 3972 adults with a diagnosis of chronic hepatitis B. MEASUREMENTS AND MAIN RESULTS: A systematic review was conducted to search for randomized clinical trials that evaluated the efficacy of nucleoside or nucleotide analogs used as monotherapy. The evaluated outcomes were reduction of HBV DNA levels, normalization of alanine aminotransferase levels, and seroconversion of hepatitis B e antigen (HBeAg). A mixed-treatment comparison was conducted to compare the odds ratios among the treatments and to rank the therapies to determine the optimal treatment option. Tenofovir had the best results among the nucleoside or nucleotide analogs for the three evaluated efficacy outcomes in both HBeAg-positive and -negative patients. CONCLUSION:Tenofovir has the highest probability of reducing HBV DNA, normalizing alanine aminotransferase levels and inducing HBeAg seroconversion after 1 year of treatment. An efficacy comparison of therapies is an important tool to guide clinicians in selecting the optimal treatment option.
Authors: S K Sarin; M Kumar; G K Lau; Z Abbas; H L Y Chan; C J Chen; D S Chen; H L Chen; P J Chen; R N Chien; A K Dokmeci; Ed Gane; J L Hou; W Jafri; J Jia; J H Kim; C L Lai; H C Lee; S G Lim; C J Liu; S Locarnini; M Al Mahtab; R Mohamed; M Omata; J Park; T Piratvisuth; B C Sharma; J Sollano; F S Wang; L Wei; M F Yuen; S S Zheng; J H Kao Journal: Hepatol Int Date: 2015-11-13 Impact factor: 6.047
Authors: Stuart Mealing; Isabella Ghement; Neil Hawkins; David A Scott; Benedicte Lescrauwaet; Maureen Watt; Mark Thursz; Pietro Lampertico; Lorenzo Mantovani; Edith Morais; Bruno Bregman; Michel Cucherat Journal: Syst Rev Date: 2014-03-07
Authors: William M Lee; Wendy C King; Harry L A Janssen; Marc G Ghany; Robert J Fontana; Michael Fried; Richard K Sterling; Jordan J Feld; Junyao Wang; Douglas B Mogul; Stewart L Cooper; Adrian M Di Bisceglie Journal: J Viral Hepat Date: 2021-08-11 Impact factor: 3.728