TY - JOUR
T1 - Tenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B
AU - Hsu, Yao Chun
AU - Wong, Grace Lai Hung
AU - Chen, Chien Hung
AU - Peng, Cheng Yuan
AU - Yeh, Ming Lun
AU - Cheung, Ka Shing
AU - Toyoda, Hidenori
AU - Huang, Chung Feng
AU - Trinh, Huy
AU - Xie, Qing
AU - Enomoto, Masaru
AU - Liu, Li
AU - Yasuda, Satoshi
AU - Tanaka, Yasuhito
AU - Kozuka, Ritsuzo
AU - Tsai, Pei Chien
AU - Huang, Yen Tsung
AU - Wong, Christopher
AU - Huang, Rui
AU - Jang, Tyng Yuan
AU - Hoang, Joseph
AU - Yang, Hwai I.
AU - Li, Jiayi
AU - Lee, Dong Hyun
AU - Takahashi, Hirokazu
AU - Zhang, Jian Q.
AU - Ogawa, Eiichi
AU - Zhao, Changqing
AU - Liu, Chenghai
AU - Furusyo, Norihiro
AU - Eguchi, Yuichiro
AU - Wong, Clifford
AU - Wu, Chao
AU - Kumada, Takashi
AU - Yuen, Man Fung
AU - Yu, Ming Lung
AU - Nguyen, Mindie H.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - INTRODUCTION: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases. RESULTS: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26-0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42-1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41-1.92; P = 0.77). DISCUSSION: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.
AB - INTRODUCTION: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). METHODS: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases. RESULTS: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26-0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42-1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41-1.92; P = 0.77). DISCUSSION: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.
UR - http://www.scopus.com/inward/record.url?scp=85079018521&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079018521&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000000428
DO - 10.14309/ajg.0000000000000428
M3 - Article
C2 - 31634265
AN - SCOPUS:85079018521
VL - 115
SP - 271
EP - 280
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 2
ER -