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Pearl Toh, 15 Jul 2019
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Lower HCC risk with tenofovir over entecavir in chronic HBV

Audrey Abella
25 Apr 2019

Patients with chronic hepatitis B virus (HBV) infection treated with the nucleot(s)ide analogue tenofovir disoproxil fumarate (TDF) had a lower risk of hepatocellular carcinoma (HCC) than those treated with entecavir, according to data from a large observational study presented at ILC 2019.

The study comprised 29,123 adults (mean age 53.7 years, 63.5 percent male) who initially received entecavir or TDF (n=27,896 and 1,227, respectively) for at least 6 months between 2008 and 2018. Individuals with a history of cancer or liver transplantation prior to or within the first 6 months of treatment were excluded. [ILC 2019, abstract LBO-03]

After a median follow-up of 3.3 years, nine (0.7 percent) TDF-treated individuals developed HCC, which was substantially lower than the number of participants who developed HCC in the entecavir arm (n=1,468, 5.3 percent).

The 5-year cumulative incidence of HCC remained lower in the TDF vs the entecavir arm (1.3 percent, 95 percent confidence interval [CI], 0.6–2.6 percent vs 7.5 percent, 95 percent CI, 7.1–7.9 percent).

TDF remained associated with a lower HCC risk than entecavir before (adjusted hazard ratio [adjHR], 0.46, 95 percent CI, 0.23–0.91; p=0.027) and after multiple imputation (weighted HR, 0.40, 95 percent CI, 0.18–0.86; p=0.019 [with propensity score weighting] and adjHR, 0.34, 95 percent CI, 0.18–0.66; p=0.001 [without propensity score weighting]).

According to the researchers, it is important to establish treatment alternatives for chronic HBV infection as this condition leads to liver inflammation, fibrosis, and cirrhosis, which could progress to decompensated liver disease and/or HCC. [Nat Rev Dis Primers 2018;4:18035] TDF and entecavir are both recommended as first-line therapy for HBV; however, current guidelines have not affirmed any preference for either drug. [Hepatology 2018;67:1560-1599; J Hepatol 2017;67:370-389; Hepatol Int 2016;10:1-98]

“[Our findings show that TDF] was associated with a significantly lower risk of HCC than entecavir in this large population of adults with chronic HBV infection,” said study investigator Dr Terry Yip from The Chinese University of Hong Kong in Hong Kong, China. Despite the inherent limitations of observational studies, the findings were consistent with those of a large Korean study reflecting a lower HCC risk with TDF vs entecavir, which further highlights the potential of TDF in reducing HCC risk, added Yip. [JAMA Oncol 2019;5:30-36; JAMA Oncol 2019;5:17-18]

 

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Most Read Articles
Pearl Toh, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
2 days ago
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.
Tristan Manalac, 3 days ago
In patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PPCI), admission Killip classification and creatinine and troponin levels are important cardiac mortality predictors, according to a recent Singapore study.