Format

Send to

Choose Destination
Clin Ther. 2013 Dec;35(12):1997-2006. doi: 10.1016/j.clinthera.2013.10.002. Epub 2013 Nov 13.

Comparison of the efficacy of Lamivudine plus adefovir versus entecavir in the treatment of Lamivudine-resistant chronic hepatitis B: a systematic review and meta-analysis.

Author information

1
Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China; Key Laboratory of Viral Hepatitis, Hunan Province, China.
2
Eight-year Program Student, Xiangya Hospital, Central South University, Changsha, China.
3
State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Zhejiang University, Hangzhou, China.
4
Department of Infectious Diseases, Hunan Provincial Corps Hospital of Chinese, People's Armed Police Forces, Changsha, China.
5
Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China.
6
Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China; Key Laboratory of Viral Hepatitis, Hunan Province, China. Electronic address: xgfan@hotmail.com.

Abstract

BACKGROUND:

Hepatitis B virus infection remains 1 of the major health threats worldwide. Currently, lamivudine plus adefovir combination therapy or entecavir monotherapy is usually used for the treatment of patients with lamivudine-resistant chronic hepatitis B (CHB). However, there are few systematic comparisons between the efficacy of lamivudine plus adefovir and the efficacy of entecavir in the treatment of these patients.

OBJECTIVE:

The goal of this systematic study and meta-analysis was to assess the efficacy of lamivudine plus adefovir compared with entecavir for the treatment of patients with lamivudine-resistant CHB.

METHODS:

A comprehensive literature search of PUBMED, Web of Science, WANFANG database, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Review, were screened to obtain citations from January 1990 to January 2012 in this study. Data analysis was done by using the Review Manager Software 5.1.

RESULTS:

Eight studies were suitable for analysis. A total of 696 patients with lamivudine-resistant CHB were studied and grouped according to treatment: 341 patients in the entecavir group and 355 patients in the lamivudine plus adefovir group. The results found that the rates of undetectable hepatitis B virus DNA levels, alanine aminotransferase normalization, hepatitis B e antigen loss, and hepatitis B e antigen seroconversion were not significantly different between the lamivudine plus adefovir group and the entecavir group. Moreover, the rate of adverse reactions was also not significantly different between the 2 groups. However, virologic breakthrough for the patients with lamivudine resistance was higher in the entecavir group than in the lamivudine plus adefovir group.

CONCLUSIONS:

For these CHB patients with lamivudine resistance, lamivudine plus adefovir was a better treatment option than entecavir alone.

KEYWORDS:

chronic hepatitis B; entecavir; lamivudine plus adefovir; lamivudine resistance

PMID:
24238791
DOI:
10.1016/j.clinthera.2013.10.002
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center