Comparison of the 48-week efficacy between entecavir and adefovir in HBeAg-positive nucleos(t)ide-naive Asian patients with chronic hepatitis B: a meta-analysis

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Comparison of the 48-week efficacy between entecavir and adefovir in

HBeAg-positive nucleos(t)ide-naive Asian patients with chronic hepatitis B: a

meta-analysis

Backgrounds: Although entacavir and adefovir were widely used in most Asian

countries, there were few conclusions drawn from a meta-analysis for comparing

the efficacy between entecavir and adefovir in nucleos(t)ide-naive Asian

patients with chronic hepatitis B (CHB). The aim of this study was to evaluate

the 48-week efficacy between the two drugs in HBeAg-positive nucleos(t)ide-naive

Asian CHB patients with the method of Meta analysis, which was generally

accepted by the international as the best evidence for evaluating the efficacy

of drugs.

Methods: We searched all data documented in Pubmed, Embase, Wanfang Database and

CNKI (China National Knowledge Infrastructure) before November 30, 2010.

Heterogeneity was examined by Chi-square test, the relative risk calculated and

forest plot drawn.

Rates of undetected serum HBV DNA, serum alanine aminotransferase (ALT)

normalization, HBeAg clearance and HBeAg seroconversion were analyzed. A total

of 6 articles was included.

Meta analysis showed that the rate of undetected serum HBV DNA (relative risk,

1.73; 95% confidence interval, 1.38-2.17; P<0.00001) and that of serum ALT

normalization (relative risk, 1.25; 95% confidence interval, 1.06-1.49; P=0.009)

in the entecavir group were higher than those in the adefovir group. However, no

statistic significance existed between the two groups in the rate of HBeAg

clearance (relative risk, 0.77; 95% confidence interval, 0.44-1.35; P=0.36), or

the rate of HBeAg seroconversion (relative risk, 0.74; 95% confidence interval,

0.28-1.94; P=0.53).

Conclusions: Entecavir is superior to adefovir in decreasing serum HBV DNA and

normalizing ALT but similar with adefovir in clearing HBeAg and encouraging

HBeAg seroconversion for the HBeAg-positive nucleos(t)ide-naive Asian patients

with chronic hepatitis B. Adefovir can be still used for first-line therapy in

these patients.

Author: Pan ZhaoWei LiuJun ZhaoQun Guan

Credits/Source: Virology Journal 2011, 8:75