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Wu X, Zhou J, Xie W, Ding H, Ou X, Chen G, Ma A, Xu X, Ma H, Xu Y, Liu X, Meng T, Wang L, Sun Y, Wang B, Kong Y, Ma H, You H, Jia J. Entecavir monotherapy versus de novo combination of lamivudine and adefovir for compensated hepatitis B virus-related cirrhosis: a real-world prospective multicenter cohort study. Infect Drug Resist 2019; 12:745-757. [PMID: 31015765 PMCID: PMC6448536 DOI: 10.2147/idr.s185120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background De novo combination of lamivudine (Lam) and adefovir (Adv) was not rarely used in clinical practice. However, head-to-head comparisons of entecavir (Etv) monotherapy with this combination in hepatitis B virus (HBV)-related compensated cirrhosis patients are unavailable. This study aimed to compare the efficacy and safety of Etv monotherapy with combination therapy in patients with HBV-related compensated liver cirrhosis. Methods Treatment-naïve patients with HBV-related compensated liver cirrhosis were recruited to receive either Etv monotherapy or a de novo combination of Lam and Adv. Data were collected at baseline and every 6 months thereafter. Results A total of 578 patients (485 in Etv group, 93 in combination group) were included. Baseline characteristics were comparable between the two groups. At the end of 1, 2, and 3 years, HBV DNA was undetectable in 82.7%, 96.2%, and 94.3% of patients in the Etv group and 88.9%, 81.7%, and 84.6% in the combination group, respectively (all P>0.05). The cumulative virological breakthrough rate at 1, 2, and 3 years was 2.7%, 6.7%, and 9.8% in the Etv group and 2.9%, 13.3%, and 32.2% in the combination group, respectively (P=0.003). After propensity-score adjustment for age, sex, and baseline HBeAg, ALT, and total bilirubin, virological breakthrough was higher in the de novo combination of Lam and Adv (HR 2.83, 95% CI 1.37–5.86; P<0.01). The cumulative rate of liver-related events, including decompensation and hepatocellular carcinoma, at 1, 2, and 3 years was 2.9%, 4.2%, and 6.1% in the Etv group and 2.2%, 2.2%, and 6.7% in combination group, respectively (P=0.83). Biochemical response and serological response were similar between the groups. Conclusion Etv treatment had less virological breakthrough and potentially higher HBV-DNA suppression than de novo combination of Lam and Adv during 3 years in treatment-naïve HBV-related compensated liver cirrhosis.
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Affiliation(s)
- Xiaoning Wu
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Jialing Zhou
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Wen Xie
- Liver Fibrosis Centre, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Huiguo Ding
- Department of Digestive Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaojuan Ou
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Guofeng Chen
- Liver Fibrosis Centre, Beijing 302 Hospital, Beijing, China
| | - Anlin Ma
- Department of Infectious Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoyuan Xu
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Hui Ma
- Liver Research Centre, Peking University People's Hospital, Beijing, China
| | - Youqing Xu
- Department of Digestive Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoqing Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Tongtong Meng
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Lin Wang
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Yameng Sun
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Bingqiong Wang
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Yuanyuan Kong
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Hong Ma
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Hong You
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
| | - Jidong Jia
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ; .,Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China, ; .,National Clinical Research Center of Digestive Diseases, Beijing, China, ;
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