Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis
The comparative risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) remains controversial. In this individual patient data (IPD) meta-analysis, we aimed to compare HCC risk between the two drugs and ident...
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| Veröffentlicht in: | Journal of hepatology 2023-03, Vol.78 (3), p.534-542 |
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| creator | Choi, Won-Mook Yip, Terry Cheuk-Fung Wong, Grace Lai-Hung Kim, W. Ray Yee, Leland J. Brooks-Rooney, Craig Curteis, Tristan Cant, Harriet Chen, Chien-Hung Chen, Chi-Yi Huang, Yi-Hsiang Jin, Young-Joo Jun, Dae Won Kim, Jin-Wook Park, Neung Hwa Peng, Cheng-Yuan Shin, Hyun Phil Shin, Jung Woo Yang, Yao-Hsu Lim, Young-Suk |
| description | The comparative risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) remains controversial. In this individual patient data (IPD) meta-analysis, we aimed to compare HCC risk between the two drugs and identify subgroups who may benefit more from one treatment than the other.
Published meta-analyses, electronic databases and congress proceedings were searched to identify eligible studies through January 2021. We compared HCC risk between the two drugs using a multivariable Cox proportional hazards model with anonymised IPD from treatment-naïve patients with CHB receiving TDF or ETV for ≥1 year. Treatment effect consistency was explored in propensity score matching (PSM), weighting (PSW) and subgroup analyses for age, sex, hepatitis B e-antigen (HBeAg) positivity, cirrhosis and diabetes status.
We included 11 studies from Korea, Taiwan and Hong Kong involving 42,939 patients receiving TDF (n = 6,979) or ETV (n = 35,960) monotherapy. Patients receiving TDF had significantly lower HCC risk (adjusted hazard ratio [HR] 0.77; 95% CI 0.61–0.98; p = 0.03). Lower HCC risk with TDF was consistently observed in PSM (HR 0.73; 95% CI 0.59–0.88; p |
| doi_str_mv | 10.1016/j.jhep.2022.12.007 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2758579198</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827822034596</els_id><sourcerecordid>2758579198</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-e38b90fb9c3c76e862ec985720a09520c3d8f1a737b63993dea892bce546f4433</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS1ERZfCH-CAfOSSMLaziY24QNXSSpW4wNlynEnXS2IvtrOov4U_i6NtOfY0Gs33njTvEfKOQc2AtR_39X6Hh5oD5zXjNUD3gmxYC1BB27CXZFMgWUneyXPyOqU9AAhQzStyLtptx0WjNuTvDR5MDhanaZlMpNZE63yYDY0u_aLO03J26HOif1zeUbuLwTtLd6vMZZfoVxrRojs6f08z-jCGo4sVPaaaFhlas669STgU8N7N6NMneuuHohgWMz3508FkQ2fMpjLeTA_JpTfkbDRTwreP84L8vL76cXlT3X3_dnv55a6yDUCuUMhewdgrK2zXomw5WiXLg2BAbTlYMciRmU50fSuUEgMaqXhvcdu0Y9MIcUE-nHwPMfxeMGU9u7QmYjyGJWnebYudYkoWlJ9QG0NKEUd9iG428UEz0Gspeq_XUvRaimZcl1KK6P2j_9LPOPyXPLVQgM8nAMuXR4dRJ1sysTi4km3WQ3DP-f8D9RyhCg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2758579198</pqid></control><display><type>article</type><title>Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Choi, Won-Mook ; Yip, Terry Cheuk-Fung ; Wong, Grace Lai-Hung ; Kim, W. Ray ; Yee, Leland J. ; Brooks-Rooney, Craig ; Curteis, Tristan ; Cant, Harriet ; Chen, Chien-Hung ; Chen, Chi-Yi ; Huang, Yi-Hsiang ; Jin, Young-Joo ; Jun, Dae Won ; Kim, Jin-Wook ; Park, Neung Hwa ; Peng, Cheng-Yuan ; Shin, Hyun Phil ; Shin, Jung Woo ; Yang, Yao-Hsu ; Lim, Young-Suk</creator><creatorcontrib>Choi, Won-Mook ; Yip, Terry Cheuk-Fung ; Wong, Grace Lai-Hung ; Kim, W. Ray ; Yee, Leland J. ; Brooks-Rooney, Craig ; Curteis, Tristan ; Cant, Harriet ; Chen, Chien-Hung ; Chen, Chi-Yi ; Huang, Yi-Hsiang ; Jin, Young-Joo ; Jun, Dae Won ; Kim, Jin-Wook ; Park, Neung Hwa ; Peng, Cheng-Yuan ; Shin, Hyun Phil ; Shin, Jung Woo ; Yang, Yao-Hsu ; Lim, Young-Suk</creatorcontrib><description>The comparative risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) remains controversial. In this individual patient data (IPD) meta-analysis, we aimed to compare HCC risk between the two drugs and identify subgroups who may benefit more from one treatment than the other.
Published meta-analyses, electronic databases and congress proceedings were searched to identify eligible studies through January 2021. We compared HCC risk between the two drugs using a multivariable Cox proportional hazards model with anonymised IPD from treatment-naïve patients with CHB receiving TDF or ETV for ≥1 year. Treatment effect consistency was explored in propensity score matching (PSM), weighting (PSW) and subgroup analyses for age, sex, hepatitis B e-antigen (HBeAg) positivity, cirrhosis and diabetes status.
We included 11 studies from Korea, Taiwan and Hong Kong involving 42,939 patients receiving TDF (n = 6,979) or ETV (n = 35,960) monotherapy. Patients receiving TDF had significantly lower HCC risk (adjusted hazard ratio [HR] 0.77; 95% CI 0.61–0.98; p = 0.03). Lower HCC risk with TDF was consistently observed in PSM (HR 0.73; 95% CI 0.59–0.88; p <0.01) and PSW (HR 0.83; 95% CI 0.67–1.03; p = 0.10) analyses and in all subgroups, with statistical significance in the ≥50 years of age (HR 0.76; 95% CI 0.58–1.00; p <0.05), male (HR 0.74; 95% CI 0.58–0.96; p = 0.02), HBeAg-positive (HR 0.69; 95% CI 0.49–0.97; p = 0.03) and non-diabetic (HR 0.79; 95% CI 0.63–1.00; p <0.05) subgroups.
TDF was associated with significantly lower HCC risk than ETV in patients with CHB, particularly those with HBeAg positivity. Longer follow-up may be needed to better define incidence differences between the treatments in various subgroups.
Previous aggregate data meta-analyses have reported inconsistent conclusions on the relative effectiveness of tenofovir disoproxil fumarate and entecavir in reducing hepatocellular carcinoma risk in patients with chronic hepatitis B (CHB).
This individual patient data meta-analysis on 11 studies involving 42,939 patients from Korea, Taiwan and Hong Kong suggested that tenofovir disoproxil fumarate-treated patients have a significantly lower hepatocellular carcinoma risk than entecavir-treated patients, which was observed in all subgroups of clinical interest and by different analytical methodologies. These findings should be taken into account by healthcare providers when determining the optimal course of treatment for patients with CHB and may be considered in ensuring that treatment guidelines for CHB remain pertinent.
[Display omitted]
•Relative HCC risk for TDF vs. ETV treatment is undetermined in patients with CHB.•Prior meta-analyses are limited by heterogeneity of observational studies.•Using individual patient data enables a consistent analytic approach across studies.•TDF was consistently associated with lower HCC risk than ETV.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2022.12.007</identifier><identifier>PMID: 36572349</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Antiviral Agents - therapeutic use ; Carcinoma, Hepatocellular - etiology ; Chronic hepatitis B ; entecavir ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic - drug therapy ; hepatocellular carcinoma ; Humans ; individual patient data ; Liver Neoplasms - etiology ; Male ; meta-analysis ; Middle Aged ; Retrospective Studies ; Tenofovir - therapeutic use ; tenofovir disoproxil fumarate ; Treatment Outcome</subject><ispartof>Journal of hepatology, 2023-03, Vol.78 (3), p.534-542</ispartof><rights>2022 The Author(s)</rights><rights>Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-e38b90fb9c3c76e862ec985720a09520c3d8f1a737b63993dea892bce546f4433</citedby><cites>FETCH-LOGICAL-c400t-e38b90fb9c3c76e862ec985720a09520c3d8f1a737b63993dea892bce546f4433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168827822034596$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36572349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Won-Mook</creatorcontrib><creatorcontrib>Yip, Terry Cheuk-Fung</creatorcontrib><creatorcontrib>Wong, Grace Lai-Hung</creatorcontrib><creatorcontrib>Kim, W. Ray</creatorcontrib><creatorcontrib>Yee, Leland J.</creatorcontrib><creatorcontrib>Brooks-Rooney, Craig</creatorcontrib><creatorcontrib>Curteis, Tristan</creatorcontrib><creatorcontrib>Cant, Harriet</creatorcontrib><creatorcontrib>Chen, Chien-Hung</creatorcontrib><creatorcontrib>Chen, Chi-Yi</creatorcontrib><creatorcontrib>Huang, Yi-Hsiang</creatorcontrib><creatorcontrib>Jin, Young-Joo</creatorcontrib><creatorcontrib>Jun, Dae Won</creatorcontrib><creatorcontrib>Kim, Jin-Wook</creatorcontrib><creatorcontrib>Park, Neung Hwa</creatorcontrib><creatorcontrib>Peng, Cheng-Yuan</creatorcontrib><creatorcontrib>Shin, Hyun Phil</creatorcontrib><creatorcontrib>Shin, Jung Woo</creatorcontrib><creatorcontrib>Yang, Yao-Hsu</creatorcontrib><creatorcontrib>Lim, Young-Suk</creatorcontrib><title>Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>The comparative risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) remains controversial. In this individual patient data (IPD) meta-analysis, we aimed to compare HCC risk between the two drugs and identify subgroups who may benefit more from one treatment than the other.
Published meta-analyses, electronic databases and congress proceedings were searched to identify eligible studies through January 2021. We compared HCC risk between the two drugs using a multivariable Cox proportional hazards model with anonymised IPD from treatment-naïve patients with CHB receiving TDF or ETV for ≥1 year. Treatment effect consistency was explored in propensity score matching (PSM), weighting (PSW) and subgroup analyses for age, sex, hepatitis B e-antigen (HBeAg) positivity, cirrhosis and diabetes status.
We included 11 studies from Korea, Taiwan and Hong Kong involving 42,939 patients receiving TDF (n = 6,979) or ETV (n = 35,960) monotherapy. Patients receiving TDF had significantly lower HCC risk (adjusted hazard ratio [HR] 0.77; 95% CI 0.61–0.98; p = 0.03). Lower HCC risk with TDF was consistently observed in PSM (HR 0.73; 95% CI 0.59–0.88; p <0.01) and PSW (HR 0.83; 95% CI 0.67–1.03; p = 0.10) analyses and in all subgroups, with statistical significance in the ≥50 years of age (HR 0.76; 95% CI 0.58–1.00; p <0.05), male (HR 0.74; 95% CI 0.58–0.96; p = 0.02), HBeAg-positive (HR 0.69; 95% CI 0.49–0.97; p = 0.03) and non-diabetic (HR 0.79; 95% CI 0.63–1.00; p <0.05) subgroups.
TDF was associated with significantly lower HCC risk than ETV in patients with CHB, particularly those with HBeAg positivity. Longer follow-up may be needed to better define incidence differences between the treatments in various subgroups.
Previous aggregate data meta-analyses have reported inconsistent conclusions on the relative effectiveness of tenofovir disoproxil fumarate and entecavir in reducing hepatocellular carcinoma risk in patients with chronic hepatitis B (CHB).
This individual patient data meta-analysis on 11 studies involving 42,939 patients from Korea, Taiwan and Hong Kong suggested that tenofovir disoproxil fumarate-treated patients have a significantly lower hepatocellular carcinoma risk than entecavir-treated patients, which was observed in all subgroups of clinical interest and by different analytical methodologies. These findings should be taken into account by healthcare providers when determining the optimal course of treatment for patients with CHB and may be considered in ensuring that treatment guidelines for CHB remain pertinent.
[Display omitted]
•Relative HCC risk for TDF vs. ETV treatment is undetermined in patients with CHB.•Prior meta-analyses are limited by heterogeneity of observational studies.•Using individual patient data enables a consistent analytic approach across studies.•TDF was consistently associated with lower HCC risk than ETV.</description><subject>Antiviral Agents - therapeutic use</subject><subject>Carcinoma, Hepatocellular - etiology</subject><subject>Chronic hepatitis B</subject><subject>entecavir</subject><subject>Female</subject><subject>Hepatitis B e Antigens</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>hepatocellular carcinoma</subject><subject>Humans</subject><subject>individual patient data</subject><subject>Liver Neoplasms - etiology</subject><subject>Male</subject><subject>meta-analysis</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Tenofovir - therapeutic use</subject><subject>tenofovir disoproxil fumarate</subject><subject>Treatment Outcome</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS1ERZfCH-CAfOSSMLaziY24QNXSSpW4wNlynEnXS2IvtrOov4U_i6NtOfY0Gs33njTvEfKOQc2AtR_39X6Hh5oD5zXjNUD3gmxYC1BB27CXZFMgWUneyXPyOqU9AAhQzStyLtptx0WjNuTvDR5MDhanaZlMpNZE63yYDY0u_aLO03J26HOif1zeUbuLwTtLd6vMZZfoVxrRojs6f08z-jCGo4sVPaaaFhlas669STgU8N7N6NMneuuHohgWMz3508FkQ2fMpjLeTA_JpTfkbDRTwreP84L8vL76cXlT3X3_dnv55a6yDUCuUMhewdgrK2zXomw5WiXLg2BAbTlYMciRmU50fSuUEgMaqXhvcdu0Y9MIcUE-nHwPMfxeMGU9u7QmYjyGJWnebYudYkoWlJ9QG0NKEUd9iG428UEz0Gspeq_XUvRaimZcl1KK6P2j_9LPOPyXPLVQgM8nAMuXR4dRJ1sysTi4km3WQ3DP-f8D9RyhCg</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Choi, Won-Mook</creator><creator>Yip, Terry Cheuk-Fung</creator><creator>Wong, Grace Lai-Hung</creator><creator>Kim, W. Ray</creator><creator>Yee, Leland J.</creator><creator>Brooks-Rooney, Craig</creator><creator>Curteis, Tristan</creator><creator>Cant, Harriet</creator><creator>Chen, Chien-Hung</creator><creator>Chen, Chi-Yi</creator><creator>Huang, Yi-Hsiang</creator><creator>Jin, Young-Joo</creator><creator>Jun, Dae Won</creator><creator>Kim, Jin-Wook</creator><creator>Park, Neung Hwa</creator><creator>Peng, Cheng-Yuan</creator><creator>Shin, Hyun Phil</creator><creator>Shin, Jung Woo</creator><creator>Yang, Yao-Hsu</creator><creator>Lim, Young-Suk</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202303</creationdate><title>Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis</title><author>Choi, Won-Mook ; Yip, Terry Cheuk-Fung ; Wong, Grace Lai-Hung ; Kim, W. Ray ; Yee, Leland J. ; Brooks-Rooney, Craig ; Curteis, Tristan ; Cant, Harriet ; Chen, Chien-Hung ; Chen, Chi-Yi ; Huang, Yi-Hsiang ; Jin, Young-Joo ; Jun, Dae Won ; Kim, Jin-Wook ; Park, Neung Hwa ; Peng, Cheng-Yuan ; Shin, Hyun Phil ; Shin, Jung Woo ; Yang, Yao-Hsu ; Lim, Young-Suk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-e38b90fb9c3c76e862ec985720a09520c3d8f1a737b63993dea892bce546f4433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antiviral Agents - therapeutic use</topic><topic>Carcinoma, Hepatocellular - etiology</topic><topic>Chronic hepatitis B</topic><topic>entecavir</topic><topic>Female</topic><topic>Hepatitis B e Antigens</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>hepatocellular carcinoma</topic><topic>Humans</topic><topic>individual patient data</topic><topic>Liver Neoplasms - etiology</topic><topic>Male</topic><topic>meta-analysis</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Tenofovir - therapeutic use</topic><topic>tenofovir disoproxil fumarate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Won-Mook</creatorcontrib><creatorcontrib>Yip, Terry Cheuk-Fung</creatorcontrib><creatorcontrib>Wong, Grace Lai-Hung</creatorcontrib><creatorcontrib>Kim, W. 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Ray</au><au>Yee, Leland J.</au><au>Brooks-Rooney, Craig</au><au>Curteis, Tristan</au><au>Cant, Harriet</au><au>Chen, Chien-Hung</au><au>Chen, Chi-Yi</au><au>Huang, Yi-Hsiang</au><au>Jin, Young-Joo</au><au>Jun, Dae Won</au><au>Kim, Jin-Wook</au><au>Park, Neung Hwa</au><au>Peng, Cheng-Yuan</au><au>Shin, Hyun Phil</au><au>Shin, Jung Woo</au><au>Yang, Yao-Hsu</au><au>Lim, Young-Suk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2023-03</date><risdate>2023</risdate><volume>78</volume><issue>3</issue><spage>534</spage><epage>542</epage><pages>534-542</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>The comparative risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) remains controversial. In this individual patient data (IPD) meta-analysis, we aimed to compare HCC risk between the two drugs and identify subgroups who may benefit more from one treatment than the other.
Published meta-analyses, electronic databases and congress proceedings were searched to identify eligible studies through January 2021. We compared HCC risk between the two drugs using a multivariable Cox proportional hazards model with anonymised IPD from treatment-naïve patients with CHB receiving TDF or ETV for ≥1 year. Treatment effect consistency was explored in propensity score matching (PSM), weighting (PSW) and subgroup analyses for age, sex, hepatitis B e-antigen (HBeAg) positivity, cirrhosis and diabetes status.
We included 11 studies from Korea, Taiwan and Hong Kong involving 42,939 patients receiving TDF (n = 6,979) or ETV (n = 35,960) monotherapy. Patients receiving TDF had significantly lower HCC risk (adjusted hazard ratio [HR] 0.77; 95% CI 0.61–0.98; p = 0.03). Lower HCC risk with TDF was consistently observed in PSM (HR 0.73; 95% CI 0.59–0.88; p <0.01) and PSW (HR 0.83; 95% CI 0.67–1.03; p = 0.10) analyses and in all subgroups, with statistical significance in the ≥50 years of age (HR 0.76; 95% CI 0.58–1.00; p <0.05), male (HR 0.74; 95% CI 0.58–0.96; p = 0.02), HBeAg-positive (HR 0.69; 95% CI 0.49–0.97; p = 0.03) and non-diabetic (HR 0.79; 95% CI 0.63–1.00; p <0.05) subgroups.
TDF was associated with significantly lower HCC risk than ETV in patients with CHB, particularly those with HBeAg positivity. Longer follow-up may be needed to better define incidence differences between the treatments in various subgroups.
Previous aggregate data meta-analyses have reported inconsistent conclusions on the relative effectiveness of tenofovir disoproxil fumarate and entecavir in reducing hepatocellular carcinoma risk in patients with chronic hepatitis B (CHB).
This individual patient data meta-analysis on 11 studies involving 42,939 patients from Korea, Taiwan and Hong Kong suggested that tenofovir disoproxil fumarate-treated patients have a significantly lower hepatocellular carcinoma risk than entecavir-treated patients, which was observed in all subgroups of clinical interest and by different analytical methodologies. These findings should be taken into account by healthcare providers when determining the optimal course of treatment for patients with CHB and may be considered in ensuring that treatment guidelines for CHB remain pertinent.
[Display omitted]
•Relative HCC risk for TDF vs. ETV treatment is undetermined in patients with CHB.•Prior meta-analyses are limited by heterogeneity of observational studies.•Using individual patient data enables a consistent analytic approach across studies.•TDF was consistently associated with lower HCC risk than ETV.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36572349</pmid><doi>10.1016/j.jhep.2022.12.007</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Antiviral Agents - therapeutic use Carcinoma, Hepatocellular - etiology Chronic hepatitis B entecavir Female Hepatitis B e Antigens Hepatitis B, Chronic - drug therapy hepatocellular carcinoma Humans individual patient data Liver Neoplasms - etiology Male meta-analysis Middle Aged Retrospective Studies Tenofovir - therapeutic use tenofovir disoproxil fumarate Treatment Outcome |
| title | Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir- vs. entecavir-based regimens: Individual patient data meta-analysis |
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