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Int J Clin Pharm. 2016 Oct;38(5):1035-43. doi: 10.1007/s11096-016-0358-6. Epub 2016 Jul 23.

Comparison of entecavir and lamivudine in preventing HBV reactivation in lymphoma patients undergoing chemotherapy: a meta-analysis.

Author information

1
Department of Medical Oncology, Sichuan Cancer Hospital and Institute, No 55, Sect. 4, South People's Road, Chengdu, 610041, Sichuan, People's Republic of China.
2
Department of Clinical Laboratory, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, People's Republic of China.
3
Department of Biostatistics, The University of Texas Health Science Center at Houston, Houston, USA.
4
McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, USA.
5
Health Management Center, Hospital of University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, People's Republic of China.
6
Department of Medical Oncology, Sichuan Cancer Hospital and Institute, No 55, Sect. 4, South People's Road, Chengdu, 610041, Sichuan, People's Republic of China. 304018651@qq.com.

Abstract

Background Multiple studies have compared the efficacy of entecavir with lamivudine in preventing hepatitis B virus (HBV) reactivation among HBV-carrying lymphoma patients with chemotherapy treatment. However, the results were slightly varied. Aim of the review to combine the findings of independent studies assessing the clinical efficacy of the two drugs using a systematic review and meta-analysis. Methods PubMed, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chongqing VIP and WanFang Data were retrieved. Two independent reviewers evaluated the study eligibility and extracted eight studies, with 770 patients in total. The meta-analysis was conducted using RevMan 5.3 and STATA software. Results HBV-carrying lymphoma patients receiving lamivudine during chemotherapy had a statistically significantly higher odds of HBV reactivation compared to those receiving entecavir (OR 5.0, 95 % CI 2.85-8.78, P < 0.001). The odds of hepatitis, HBV-Reactivation caused hepatitis and chemotherapy disruption was statistically significantly elevated in the patient group receiving lamivudine compared to the entecavir group (OR 4.12, 95 % CI 1.70-9.98, P = 0.002; OR 11.44, 95 % CI 2.70-48.52, P < 0.001; OR 6.71, 95 % CI 2.34-19.26, P < 0.001, respectively). Furthermore, the HBV reactivation rate in Ann Arbor stages I - II patient group was statistically significantly lower than the one in Ann Arbor stages III-IV group, with an overall pooled value of 0.37 (95 % CI 0.17-0.82, P = 0.01). Conclusion The metaanalysis result suggested that among HBV-carrying lymphoma patients undergoing chemotherapy, entecavir is more effective than lamivudine in preventing HBV reactivation.

KEYWORDS:

Entecavir; Lamivudine; Lymphoma; Meta-analysis; Review

PMID:
27450506
DOI:
10.1007/s11096-016-0358-6
[Indexed for MEDLINE]

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