替诺福韦酯与恩替卡韦治疗慢性乙型肝炎有效性的网状Meta分析

Efficacy of tenofovir dipivoxil and entecavir in treatment of chronic hepatitis B: a network meta-analysis

    摘要
  • 摘要: 目的 评估替诺福韦酯与恩替卡韦在治疗慢性乙肝有效性及安全性的网状Meta分析。方法 检索Pubmed/Medicine,Embase,Cochrane图书馆、中国生物医学文献服务系统(SinoMed)数据库,文献关于替诺福韦酯与恩替卡韦的对照研究及队列研究,检索时间至2017年7月,由两名作者对检索数据进行提取与总结,运用Stata 12.0对数据进行统计分析,并对纳入文献进行敏感性分析,运用Egger,s或Beggr,s检测其发表偏倚。结果 共纳入此次网状Meta分析文献共22篇,对比替诺福韦酯与恩替卡韦治疗HBV-DNA有效性方面,按照口服抗病毒药物时间,可分为5个亚组,12周、24周、48周、72周、96周,其相对危险度RR与可信区间CI分别为:RR=1.14,CI(0.92~1.42),I2=13.3% P=0.318;RR=1.05 ,CI(0.96~1.13) I2=23.8% P=0.173;RR=1.04,CI(0.98~1.11)I2=11.1% P=0.322;RR=1.16 CI(1.02~1.32)I2=78.4%;RR=1.07 CI (1.01~1.13)I2=62.3% P=0.01,替诺福韦酯与恩替卡韦在治疗慢性乙肝谷丙转氨酶(ALT)复常率方面,将研究按随访时间分为12周、24周、48周,三个亚组相对危险度及可信区间分别为:RR=1.16,CI (0.92~1.46)P=0.022 I2=61.8%;RR=0.98,CI(0.89~1.07)P=0.121 I2=38.8%;RR=0.99,CI(0.95~1.03) P=0.880 I2=0。结论 当随访时间在48周以内时,口服替诺福韦酯与恩替卡韦有效性无明显差异,但随着随访时间延长到72周,口服替诺福韦酯与恩替卡韦有明显差异,前者在根除HBV-DNA有效性方面优于后者,而二者在谷丙转氨酶复常率方面无明显差异。

     

    Abstract: OBJECTIVE To evaluate the efficacy and safety of tenofovir dipivoxil and entecavir in treatment of chronic hepatitis B and conduct a network meta-analysis.METHODS The literatures in regard to the control, cohort study of tenofovir dipivoxil and entecavir were retrieved in the databases till Jul, 2017, including Pubmed/Medicine,Embase,Cochrane library and SinoMed, the retrieved data were extracted and summarized by two authors, the statistical analysis was performed by using Stata 12.0, the heterogeneity of the enrolled literatures was analyzed, and the publication bias was detected by using Egger,s or Beggr,s.RESULTS Totally 22 literatures were included in the network meta-analysis, the efficacy of tenofovir dipivoxil and entecavir in treatment of HBV-DNA was compared, the enrolled literatures were divided into 5 subgroups according to the time of oral administration of antiviral drugs, 12-week group, 24-week group, 48-week group, 72-week group and 96-week group; the relative risk (RR) were 1.14, 1.05, 1.04, 1.16 and 1.07, respectively; the confidence intervals (CI) were (0.92~1.42),I2=13.3% P=0.318, (0.96~1.13) I2=23.8% P=0.173, (0.98~1.11)I2=11.1% P=0.322, (1.02~HT5"SS1.32)I2=78.4% and (1.01~1.13)I2=62.3% P=0.01, respectively. According to the tenofovir dipivoxil and entecavir in treatment of recovery rate of alanine transaminase (ALT), the enrolled literatures were divided into three subgroups according to the follow-up time: the 12-week group, 24-week group and 48-week group; the RR of the three subgroups were 1.16, 0.98 and 0.99, respectively; the CIs were (0.92~1.46)P=0.022 I2=61.8%, (0.89~1.07)P=0.121 I2=38.8% and (0.95~1.03) P=0.880 I2=0, respectively.CONCLUSION There is no significant difference in the efficacy between oral administration of tenofovir dipivoxil and entecavir within 48 hours of follow-up, however, there is significant difference in the efficacy between oral administration of tenofovir dipivoxil and entecavir with the follow-up extending to 72 weeks, the efficacy of tenofovir dipivoxil is better than that of entecavir in eradication of HBV-DNA, but there is no significant difference in the recovery rate of ALT.

     

    • HTML全文
    • 参考文献(0)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回
下载中心