Entecavir comparable to tenofovir for treatment-naïve chronic hepatitis B patients
Entecavir and tenofovir deliver similar prognostic benefits in chronic hepatitis B (CHB) patients naïve to any treatment, a new study has shown.
Researchers enrolled 2,897 CHB patients who were given either entecavir (n=1,484; mean age, 48.2±11.5 years; 59.9 percent male) or tenofovir (n=1,413; mean age, 48.8±12.0 years; 64.6 percent male) as first-line antiviral agents. Patients with hepatocellular carcinoma (HCC) or decompensated cirrhosis were ineligible. Study outcomes included the cumulative probabilities of HCC and death, or the need for orthotopic liver transplant (OLT).
In the overall study population, 240 participants developed HCC, resulting in an incidence rate of 8.3 percent. Analysis according to treatment arms showed that the 1-, 3- and 5-year cumulative HCC risks in the entecavir group were 1.0 percent, 4.8 percent and 9.3 percent, respectively. Corresponding values in the tenofovir group were 1.0 percent, 4.7 percent and 7.7 percent (p=0.517).
Multivariate analysis revealed no significant difference in HCC risk between the two groups (adjusted hazard ratio [HR], 0.975, 95 percent CI, 0.747–1.272; p=0.852).
A similar trend was reported for death and OLT, which was reported in 2.5 percent (n=72) of the entire cohort. The respective cumulative risk rates at 1, 3 and 5 years were 0.5 percent, 1.8 percent and 2.6 percent in the entecavir group, and 0.2 percent, 1.4 percent and 2.5 percent in the tenofovir group (p=0.981).
The likelihood of death or OLT was likewise comparable between treatment arms (adjusted HR, 1.202, 0.745–1.939; p=0.451).