Nucleos(t)ide analogues for the treatment of chronic hepatitis B: a systematic review with network meta-analysis

被引：6
作者：
Geng, JinSong [1 ]
Bao, HaiNi [1 ]
Chen, YaLan [1 ]
Shi, LiLi [1 ]
Geng, Jing [2 ]
Wang, Qing [3 ]
Yu, Hao [4 ,5 ]
机构：
[1] Nantong Univ, Evidence Based Med Ctr, Med Sch, Nantong, Jiangsu, Peoples R China
[2] Lianyungang 1 Peoples Hosp, Dept Gastroenterol, Lianyungang, Jiangsu, Peoples R China
[3] Ningxiang Peoples Hosp, Dept Infect Dis, Ningxiang, Hunan, Peoples R China
[4] Harvard Med Sch, Dept Populat Med, Boston, MA 02115 USA
[5] Harvard Pilgrim Hlth Care Inst, Boston, MA USA
来源：
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY | 2020年 / 18卷 / 08期
基金：
中国国家自然科学基金;
关键词：
Chronic hepatitis B; nucleos(t)ide analogues; systematic review; network meta-analysis; treatment; POSITIVE CHRONIC HEPATITIS; TENOFOVIR DISOPROXIL FUMARATE; 96-WEEK RANDOMIZED-TRIAL; ISPOR TASK-FORCE; E-ANTIGEN; ADEFOVIR DIPIVOXIL; COMBINATION THERAPY; VIRUS INFECTION; NAIVE PATIENTS; DOUBLE-BLIND;
D O I：
10.1080/14787210.2020.1760843
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
Objectives: Chronic hepatitis B (CHB) is a major global health problem caused by hepatitis B virus (HBV) infection, and can put patients at high risk of death from cirrhosis and liver cancer. However, CHB can be treated with nucleos(t)ide analogues. We aimed to evaluate the effectiveness and safety of nucleos(t)ide analogues for the treatment of CHB patients. Methods: A systematic literature search was performed. Direct comparison meta-analyses and network meta-analysis (NMA) were carried out. Results: Thirty-six randomized controlled trials (RCTs) met inclusion criteria. Compared with placebo, the nucleos(t)ide analogues were all effective in HBeAg seroconversion, HBeAg loss, and achieving undetectable HBV DNA. Telbivudine was associated with higher HBeAg seroconversion compared with entecavir. For HBeAg loss rate and proportion of achieving undetectable HBV DNA, tenofovir ranked as the best. Entecavir might be the most potent in the normalization of alanine aminotransferase (ALT). The nucleos(t)ide analogues did not have higher serious adverse events rate as compared with placebo. Conclusion: The nucleos(t)ide analogues are all effective for HBeAg seroconversion, HBeAg loss, undetectable HBV DNA, and most are effective for ALT normalization in adults with CHB. RCTs of multi-center, low risk of bias, and long-term follow-up are still needed.
引用
收藏
页码：823 / 833
页数：11
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