Journals / Turkish Journal of Gastroenterology / 2013 / Cilt: 24 - Sayı: 3
HBeAg pozitif kronik hepatit B'li Asya'lı hastalarda kırksekiz haftalık telbivudin ve entekavirin etkinliğinin karşılaştırılması: Bir meta-analiz
- Pages
- 230–240
- DOI
- —
Abstract
Background/aims: Telbivudine and entecavir are two pharmacologic agents recommended and also widely used for the treatment of chronic hepatitis B in most Asian countries. There are few conclusive results when comparing the efficacy of these two drugs for the treatment of chronic hepatitis B. The aim of this study is to evaluate, by means of meta-analysis, the short-term efficacy betwe- en the two drugs in nucleos(t)ide-naıïve Asian HBeAg-positive chronic hepatitis B patients. Materials and Methods: We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, the Wanfang Database and CNKI (National Knowledge In- frastructure). Twelve eligible trials (1011 patients in total) were included into this study, and they were evaluated for quality and heterogeneity. Results: Meta-analysis date showed the rate of HBeAg clearance and rate of HBeAg seroconversion in the telbivudi- ne group was higher than the entecavir group, respectively. There was no statistically significant difference however between the two groups in the rate of alanine aminotransferase normalization, or the rate of HBV DNA suppression. Although creatine kinase ele- vations occurred more frequently in the telbivudine group than when compared to the entecavir group, there was no statistically sig- nificant difference between the two groups in the short-term treatment duration. Conclusions: For the short-term treatment of HBe- Ag-positive nucleos(t)ide-naıïve Asian patients with chronic hepatitis B, telbivudine is as potent as entecavir in normalizing alanine aminotransferase and suppressing HBV DNA, and telbivudine is superior to entecavir in clearing HBeAg and developing anti-HBe. Careful monitoring is needed to avoid adverse events, as well as drug resistance during antiviral therapy with telbivudine
Özet
Background/aims: Telbivudine and entecavir are two pharmacologic agents recommended and also widely used for the treatment of chronic hepatitis B in most Asian countries. There are few conclusive results when comparing the efficacy of these two drugs for the treatment of chronic hepatitis B. The aim of this study is to evaluate, by means of meta-analysis, the short-term efficacy betwe- en the two drugs in nucleos(t)ide-naıïve Asian HBeAg-positive chronic hepatitis B patients. Materials and Methods: We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, the Wanfang Database and CNKI (National Knowledge In- frastructure). Twelve eligible trials (1011 patients in total) were included into this study, and they were evaluated for quality and heterogeneity. Results: Meta-analysis date showed the rate of HBeAg clearance and rate of HBeAg seroconversion in the telbivudi- ne group was higher than the entecavir group, respectively. There was no statistically significant difference however between the two groups in the rate of alanine aminotransferase normalization, or the rate of HBV DNA suppression. Although creatine kinase ele- vations occurred more frequently in the telbivudine group than when compared to the entecavir group, there was no statistically sig- nificant difference between the two groups in the short-term treatment duration. Conclusions: For the short-term treatment of HBe- Ag-positive nucleos(t)ide-naıïve Asian patients with chronic hepatitis B, telbivudine is as potent as entecavir in normalizing alanine aminotransferase and suppressing HBV DNA, and telbivudine is superior to entecavir in clearing HBeAg and developing anti-HBe. Careful monitoring is needed to avoid adverse events, as well as drug resistance during antiviral therapy with telbivudine