<p>Entecavir monotherapy versus de novo combination of lamivudine and adefovir for compensated hepatitis B virus-related cirrhosis: a real-world prospective multicenter cohort study</p>

Abstract

Background De novo combination of lamivudine (Lam) and adefovir (Adv) was not rarely used in clinical practice. However, head-to-head comparisons of entecavir (Etv) monotherapy with this combination in hepatitis B virus (HBV)-related compensated cirrhosis patients are unavailable. This study aimed to compare the efficacy and safety of Etv monotherapy with combination therapy in patients with HBV-related compensated liver cirrhosis. Methods Treatment-naïve patients with HBV-related compensated liver cirrhosis were recruited to receive either Etv monotherapy or a de novo combination of Lam and Adv. Data were collected at baseline and every 6 months thereafter. Results A total of 578 patients (485 in Etv group, 93 in combination group) were included. Baseline characteristics were comparable between the two groups. At the end of 1, 2, and 3 years, HBV DNA was undetectable in 82.7%, 96.2%, and 94.3% of patients in the Etv group and 88.9%, 81.7%, and 84.6% in the combination group, respectively (all P >0.05). The cumulative virological breakthrough rate at 1, 2, and 3 years was 2.7%, 6.7%, and 9.8% in the Etv group and 2.9%, 13.3%, and 32.2% in the combination group, respectively ( P =0.003). After propensity-score adjustment for age, sex, and baseline HBeAg, ALT, and total bilirubin, virological breakthrough was higher in the de novo combination of Lam and Adv (HR 2.83, 95% CI 1.37–5.86; P <0.01). The cumulative rate of liver-related events, including decompensation and hepatocellular carcinoma, at 1, 2, and 3 years was 2.9%, 4.2%, and 6.1% in the Etv group and 2.2%, 2.2%, and 6.7% in combination group, respectively ( P =0.83). Biochemical response and serological response were similar between the groups. Conclusion Etv treatment had less virological breakthrough and potentially higher HBV-DNA suppression than de novo combination of Lam and Adv during 3 years in treatment-naïve HBV-related compensated liver cirrhosis.

Screening varices in patients with HBV‐related cirrhosis on antiviral therapy: Platelet alone or together with LSM

“…Compensated HBV‐cirrhosis who underwent screening EGD during antiviral therapy were reviewed for this study (Figure 1). One data source was derived from the follow‐up data of chronic hepatitis B patients receiving nucleoside (acid) analogue (NUC)‐based therapy (ClinicalTrials.gov NCT03366571 & NCT02849132) 14,15 . The other data source was the screening data of a study aimed to evaluate the efficacy of carvedilol in preventing the progression of small varices in HBV‐cirrhosis treated with antiviral therapy (ClinicalTrials.gov NCT03736265).…”

An integrated vitamin E-coated polymer hybrid nanoplatform: A lucrative option for an enhanced in vitro macrophage retention for an anti-hepatitis B therapeutic prospect

“…Among the antiviral nucleot(s)ide analogues, entecavir (E), has been highly recommended due to various merits: (i) potency, (ii) low resistance, and (iii) low systemic toxicity [8][9][10]. In a very recent multicenter cohort study conducted by Chinese researchers, E monotherapy offered evidence of lowered virological breakthrough and heightened HBV-DNA suppression compared to combination therapy of antiviral agents; lamivudine and adefovir [9]. Zoutendijk and coworkers suggested E monotherapy for 48 weeks [11].…”

Long-Term Outcomes in Chinese Patients with Chronic Hepatitis B Receiving Nucleoside/Nucleotide Analogue Therapy in Real-World Clinical Practice: 5-Year Results from the EVOLVE Study

“…Overall, the cumulative serological response rates were high during the study; however, the HBeAg clearance and seroconversion rates at 5 years (13.2% and 6.3% with ETV and 14.3% and 5.7% with LAM-based) was lower than previously reported with ETV and LAM-based therapies [15,19,28]. In the NA-naive China cohort of the REALM study, the HBeAg clearance and seroconversion rates were 17% and 15%, respectively, with ETV therapy at 1 year [15].…”