A meta‐analysis comparing the efficacy of entecavir and tenofovir for the treatment of chronic hepatitis B infection

Abstract

The efficacy of entecavir and tenofovir in patients with chronic hepatitis B virus (HBV) is inconsistent. To address this issue, we conducted a meta-analysis based on a current review of the literature addressing the efficacy and safety of entecavir and tenofovir. Electronic databases were searched through June 2014 for relevant clinical trials. We included 2 randomized controlled trials, 2 prospective cohort studies, and 7 case-control studies that included 1,656 patients. In the entecavir group, 842 of 992 were nucleos(t)ide-naïve chronic HBV patients, and in the tenofovir group 481 of 664 were nucleos(t)ide-naïve. The virological response to tenofovir was superior to entecavir (RR: 0.82; 95%CI: 0.72-0.93), especially in nucleos(t)ide-naïve chronic HBV patients at 48 weeks (RR: 0.78; 95%CI: 0.65-0.92). Additionally, there was no difference between entecavir and tenofovir for virological response at 24 weeks (RR: 0.87, 95%CI: 0.71-1.05). The alanine aminotransferase normalization rate, serological response, and adverse event rate were also not significantly different between entecavir and tenofovir at 24 or 48 weeks after treatment. These results suggest that tenofovir is a better choice to treat chronic HBV patients than entecavir as it is better able to suppress HBV viral load and has a similar safety profile.

Long‐term safety and efficacy of nucleo(t)side analogue therapy in hepatitis B

“…[12][13][14][15] In a meta-analysis of 11 studies comparing ETV and TDF in 1300 patients, no statistically significant differences were found between these agents for renal safety or hypophosphatemia over approximately 18 months. 16 However, renal toxicity (defined as a confirmed change in serum creatinine of 0.5 mg/dL from baseline, a decrease in creatinine clearance [CrCL] <50 mL/min and/or serum phosphorus <2 mg/ dL) was observed in approximately 8% of patients in a trial that followed 280 patients receiving TDF for 240 weeks. 17 Table 2 shows the safety results in clinical practice in different studies.…”

Comparison of the efficacy and safety of entecavir and tenofovir in nucleos(t)ide analogue-naive chronic hepatitis B patients with high viraemia: a retrospective cohort study

“…With regard to drug safety, some reports indicate that patients taking tenofovir may develop nephrotoxicity [6,7]. Two recent meta-analysis studies yielded inconsistent results, especially in comparisons of virological responses (VR) [8,9]. Güzelbulut et al found that entecavir and tenofovir are similarly effective in nucleos(t)ide (NA) -naive CHB patients with high viraemia ( 6 log copies/mL in hepatitis B e antigen (HBeAg)-positive patients or 5 log copies/mL in HBeAg-negative patients) after 48 weeks of therapy [10].…”

Abstracts

“…In a meta‐analysis of 11 studies comparing ETV and TDF in 1300 patients, no statistically significant differences were found for renal safety or hypophosphatemia between the two treatments over approximately 18 months of treatment 5 . TAF is being evaluated in 2 ongoing randomized, double‐blind, phase 3 studies including 426 HBeAg(‐) and 875 HBeAg(+) patients with CHB.…”