Ji-Na Zheng1,2, Tian-Tian Zou1,3, Hai Zou4, Gui-Qi Zhu1,2, Lu-Yi Ruan1,2, Zhang Cheng1,2, Sven Van Poucke5, Ming-Hua Zheng1,6. 1. a Department of Hepatology, Liver Research Center , the First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China. 2. b School of the First Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China. 3. c School of the Second Clinical Medical Sciences , Wenzhou Medical University , Wenzhou , China. 4. d Department of Infection Diseases , Zhejiang Provincial People's Hospital , Hangzhou , China. 5. e Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy , Ziekenhuis Oost-Limburg , Genk , Belgium. 6. f Institute of Hepatology , Wenzhou Medical University , Wenzhou , China.
Abstract
BACKGROUND: Prophylactic nucleos(t)ide anologues against hepatitis B virus (HBV) recurrence after liver transplantation (LT) include lamivudine, entecavir, tenofovir, adefovir. Since the most effective strategies for post-LT remain inconclusive, we aimed to compare 6 different treatment options (lamivudine, entecavir, tenofovir, adefovir, lamivudine plus adefovir, lamivudine plus tenofovir) in terms of HBV recurrence after LT using network meta-analysis. METHODS: The search identified seventeen studies involving 6 different prophylactic regimens covering 7274 patients. RESULTS: Compared with entecavir, lamivudine plus tenofovir (OR 2.00, 95%CI 0.02-183.29), lamivudine plus adefovir, (OR 2.83, 95%CI 0.18-33.57), tenofovir (OR 1.11, 95%CI 0.22-5.80), adefovir (OR 3.78, 95%CI 0.59-22.16), lamivudine (OR 4.62, 95%CI 1.75-11.39) were associated with an increased risk of HBV recurrence. CONCLUSION: Entecavir resulted with the highest probability (31%) as the best prophylactic option on reducing the risk of HBV recurrence. Entecavir is the preferred oral NAs treatment compared to other five different prophylactic regimens in the prevention of HBV recurrence after LT.
BACKGROUND: Prophylactic nucleos(t)ide anologues against hepatitis B virus (HBV) recurrence after liver transplantation (LT) include lamivudine, entecavir, tenofovir, adefovir. Since the most effective strategies for post-LT remain inconclusive, we aimed to compare 6 different treatment options (lamivudine, entecavir, tenofovir, adefovir, lamivudine plus adefovir, lamivudine plus tenofovir) in terms of HBV recurrence after LT using network meta-analysis. METHODS: The search identified seventeen studies involving 6 different prophylactic regimens covering 7274 patients. RESULTS: Compared with entecavir, lamivudine plus tenofovir (OR 2.00, 95%CI 0.02-183.29), lamivudine plus adefovir, (OR 2.83, 95%CI 0.18-33.57), tenofovir (OR 1.11, 95%CI 0.22-5.80), adefovir (OR 3.78, 95%CI 0.59-22.16), lamivudine (OR 4.62, 95%CI 1.75-11.39) were associated with an increased risk of HBV recurrence. CONCLUSION:Entecavir resulted with the highest probability (31%) as the best prophylactic option on reducing the risk of HBV recurrence. Entecavir is the preferred oral NAs treatment compared to other five different prophylactic regimens in the prevention of HBV recurrence after LT.
Authors: Danielle J Smalls; Reagan E Kiger; LeAnn B Norris; Charles L Bennett; Bryan L Love Journal: Pharmacotherapy Date: 2019-11-03 Impact factor: 4.705