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Entecavir-based combination therapies for chronic hepatitis B: A meta-analysis
Aoran Luo1, Xiaoyan Jiang, Hong Ren
1Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, PR China.
Medicine
|December 22, 2018
Summary
Entecavir (ETV) monotherapy and ETV-based combination therapy show similar efficacy for chronic hepatitis B (CHB) patients. Further research is needed to confirm these findings on CHB treatment effectiveness.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Chronic hepatitis B (CHB) management lacks consensus on optimal antiviral strategies.
- Entecavir (ETV) is a key treatment, but its monotherapy versus combination therapy efficacy remains debated.
Purpose of the Study:
- To compare the efficacy and safety of entecavir (ETV) monotherapy against ETV-based combination therapy in chronic hepatitis B (CHB) patients.
- To evaluate treatment outcomes across different patient groups: nucleos(t)ide-naive, nucleos(t)ide-resistant, and those with undetectable HBV DNA.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Embase, Web of Science, Cochrane, CMBD).
- Included studies were randomized clinical trials (RCTs) and cohort studies.
- Pooled outcomes, including undetectable HBV DNA rates, HBeAg loss, ALT normalization, and HBV DNA relapse, were analyzed using odds ratios (OR) and mean differences (MD).
Main Results:
- For nucleos(t)ide-naive (Group A) and nucleos(t)ide-resistant (Group B) patients, entecavir monotherapy demonstrated superior rates of undetectable HBV DNA compared to combination therapy.
- HBeAg loss and ALT normalization rates were similar between monotherapy and combination therapy groups.
- For patients with undetectable HBV DNA (Group C), ETV-based combination therapy showed a better rate of preventing HBV DNA relapse.
Conclusions:
- Current evidence suggests entecavir-based combination therapy offers no significant advantage over entecavir monotherapy for most chronic hepatitis B treatment outcomes.
- Further high-quality studies are necessary to definitively establish the optimal therapeutic strategy for CHB patients.
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