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

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.