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

JinSong Geng1, HaiNi Bao1, YaLan Chen1

  • 1Evidence-based Medicine Center, Medical School of Nantong University , Jiangsu, China.

Expert Review of Anti-Infective Therapy
|April 25, 2020
PubMed

Insights

Nucleos(t)ide analogues effectively treat chronic hepatitis B (CHB) by improving viral DNA levels and seroconversion markers. These treatments are safe, with no increased serious adverse events compared to placebo.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic hepatitis B (CHB) is a significant global health concern, leading to severe liver disease.
  • Hepatitis B virus (HBV) infection necessitates effective therapeutic strategies to prevent cirrhosis and liver cancer.

Purpose of the Study:

  • To evaluate the efficacy and safety of nucleos(t)ide analogues for treating CHB.
  • To compare the effectiveness of different nucleos(t)ide analogues in managing CHB.

Main Methods:

  • Systematic literature search and meta-analyses, including direct comparison and network meta-analysis (NMA).
  • Inclusion of 36 randomized controlled trials (RCTs) comparing nucleos(t)ide analogues against placebo or each other.

Main Results:

  • Nucleos(t)ide analogues demonstrated efficacy in HBeAg seroconversion, HBeAg loss, and achieving undetectable HBV DNA compared to placebo.
  • Tenofovir showed the best performance for HBeAg loss and undetectable HBV DNA, while entecavir was potent for ALT normalization.
  • No significant increase in serious adverse events was observed with nucleos(t)ide analogues versus placebo.

Conclusions:

  • Nucleos(t)ide analogues are effective treatments for CHB, improving key virological and biochemical markers.
  • Further high-quality, long-term RCTs are recommended to solidify findings and guide clinical practice.
Abstract

Keywords:
Chronic hepatitis Bnetwork meta-analysisnucleos(t)ide analoguessystematic reviewtreatment

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