Systematic review with network meta-analysis: Comparative efficacy of oral nucleos(t)ide analogues for the prevention of chemotherapy-induced hepatitis B virus reactivation
Currently, no consensus exists regarding the optimal oral prophylactic regimens for hepatitis B surface antigen seropositive patients undergoing chemotherapy. We aimed to compare the efficacy of oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir,...
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creator | Zhang, Min-Yue Zhu, Gui-Qi Shi, Ke-Qing Zheng, Ji-Na Cheng, Zhang Zou, Zhuo-Lin Huang, Hong-Hui Chen, Fang-Yuan Zheng, Ming-Hua |
description | Currently, no consensus exists regarding the optimal oral prophylactic regimens for hepatitis B surface antigen seropositive patients undergoing chemotherapy. We aimed to compare the efficacy of oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of chemotherapy-induced hepatitis B virus (HBV) reactivation and its related morbidity and mortality in patients with chronic HBV (CHB) infection.
Fifty-two eligible articles consisting of 3892 participants were included. For HBV reactivation, prophylactic treatment with NAs were all significantly superior to no prophylaxis, with odds ratio (OR) from 0.00 (95% confidence interval [CI] 0.00~0.04) for the most effective intervention (tenofovir) to 0.10 (95% CI 0.06~0.14) for the least effective intervention (lamivudine). For secondary outcomes, prophylaxis with NAs also significantly outperformed observation. The results suggested that entecavir reduced the risk of HBV related hepatitis (predicted probability, 83%), HBV related death (68%) and all causes of hepatitis (97%) most efficaciously. It ranked second in decreasing all causes of death (34%).
PubMed, Embase and Cochrane Library database were searched for controlled trials up to March 31, 2015. Primary outcome was the incidence of HBV reactivation. Secondary outcomes included the incidence of HBV-related hepatitis and death, all causes of hepatitis and death. Network meta-analysis combined direct and indirect evidence to estimate ORs for the clinical outcomes. A mean ranking and the probability of optimal therapeutic regime was obtained for each treatment based on clinical outcomes.
Available evidence suggests that prophylatic therapy with tenofovir and entecavir may be the most potent interventions in prevention of HBV reactivation and HBV-related morbidity and mortality for CHB infection patients undergoing chemotherapy. |
doi_str_mv | 10.18632/oncotarget.8907 |
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Fifty-two eligible articles consisting of 3892 participants were included. For HBV reactivation, prophylactic treatment with NAs were all significantly superior to no prophylaxis, with odds ratio (OR) from 0.00 (95% confidence interval [CI] 0.00~0.04) for the most effective intervention (tenofovir) to 0.10 (95% CI 0.06~0.14) for the least effective intervention (lamivudine). For secondary outcomes, prophylaxis with NAs also significantly outperformed observation. The results suggested that entecavir reduced the risk of HBV related hepatitis (predicted probability, 83%), HBV related death (68%) and all causes of hepatitis (97%) most efficaciously. It ranked second in decreasing all causes of death (34%).
PubMed, Embase and Cochrane Library database were searched for controlled trials up to March 31, 2015. Primary outcome was the incidence of HBV reactivation. Secondary outcomes included the incidence of HBV-related hepatitis and death, all causes of hepatitis and death. Network meta-analysis combined direct and indirect evidence to estimate ORs for the clinical outcomes. A mean ranking and the probability of optimal therapeutic regime was obtained for each treatment based on clinical outcomes.
Available evidence suggests that prophylatic therapy with tenofovir and entecavir may be the most potent interventions in prevention of HBV reactivation and HBV-related morbidity and mortality for CHB infection patients undergoing chemotherapy.</description><identifier>ISSN: 1949-2553</identifier><identifier>EISSN: 1949-2553</identifier><identifier>DOI: 10.18632/oncotarget.8907</identifier><identifier>PMID: 27121321</identifier><language>eng</language><publisher>United States: Impact Journals LLC</publisher><subject>Adenine - analogs & derivatives ; Adenine - therapeutic use ; Antineoplastic Agents - adverse effects ; Antiviral Agents - therapeutic use ; Controlled Clinical Trials as Topic ; Guanine - analogs & derivatives ; Guanine - therapeutic use ; Hepatitis B - chemically induced ; Hepatitis B - prevention & control ; Hepatitis B - virology ; Hepatitis B virus - drug effects ; Hepatitis B virus - physiology ; Host-Pathogen Interactions - drug effects ; Humans ; Lamivudine - therapeutic use ; Organophosphonates - therapeutic use ; Research Paper ; Thymidine - analogs & derivatives ; Thymidine - therapeutic use ; Virus Activation - drug effects</subject><ispartof>Oncotarget, 2016-05, Vol.7 (21), p.30642-30658</ispartof><rights>Copyright: © 2016 Zhang et al. 2016</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-dc771ed793c06999138aba890a90bfa1f4e9ebdcc9e06c2f461b0ffddb5bf9123</citedby><cites>FETCH-LOGICAL-c354t-dc771ed793c06999138aba890a90bfa1f4e9ebdcc9e06c2f461b0ffddb5bf9123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058707/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058707/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,887,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27121321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Min-Yue</creatorcontrib><creatorcontrib>Zhu, Gui-Qi</creatorcontrib><creatorcontrib>Shi, Ke-Qing</creatorcontrib><creatorcontrib>Zheng, Ji-Na</creatorcontrib><creatorcontrib>Cheng, Zhang</creatorcontrib><creatorcontrib>Zou, Zhuo-Lin</creatorcontrib><creatorcontrib>Huang, Hong-Hui</creatorcontrib><creatorcontrib>Chen, Fang-Yuan</creatorcontrib><creatorcontrib>Zheng, Ming-Hua</creatorcontrib><title>Systematic review with network meta-analysis: Comparative efficacy of oral nucleos(t)ide analogues for the prevention of chemotherapy-induced hepatitis B virus reactivation</title><title>Oncotarget</title><addtitle>Oncotarget</addtitle><description>Currently, no consensus exists regarding the optimal oral prophylactic regimens for hepatitis B surface antigen seropositive patients undergoing chemotherapy. We aimed to compare the efficacy of oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of chemotherapy-induced hepatitis B virus (HBV) reactivation and its related morbidity and mortality in patients with chronic HBV (CHB) infection.
Fifty-two eligible articles consisting of 3892 participants were included. For HBV reactivation, prophylactic treatment with NAs were all significantly superior to no prophylaxis, with odds ratio (OR) from 0.00 (95% confidence interval [CI] 0.00~0.04) for the most effective intervention (tenofovir) to 0.10 (95% CI 0.06~0.14) for the least effective intervention (lamivudine). For secondary outcomes, prophylaxis with NAs also significantly outperformed observation. The results suggested that entecavir reduced the risk of HBV related hepatitis (predicted probability, 83%), HBV related death (68%) and all causes of hepatitis (97%) most efficaciously. It ranked second in decreasing all causes of death (34%).
PubMed, Embase and Cochrane Library database were searched for controlled trials up to March 31, 2015. Primary outcome was the incidence of HBV reactivation. Secondary outcomes included the incidence of HBV-related hepatitis and death, all causes of hepatitis and death. Network meta-analysis combined direct and indirect evidence to estimate ORs for the clinical outcomes. A mean ranking and the probability of optimal therapeutic regime was obtained for each treatment based on clinical outcomes.
Available evidence suggests that prophylatic therapy with tenofovir and entecavir may be the most potent interventions in prevention of HBV reactivation and HBV-related morbidity and mortality for CHB infection patients undergoing chemotherapy.</description><subject>Adenine - analogs & derivatives</subject><subject>Adenine - therapeutic use</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Controlled Clinical Trials as Topic</subject><subject>Guanine - analogs & derivatives</subject><subject>Guanine - therapeutic use</subject><subject>Hepatitis B - chemically induced</subject><subject>Hepatitis B - prevention & control</subject><subject>Hepatitis B - virology</subject><subject>Hepatitis B virus - drug effects</subject><subject>Hepatitis B virus - physiology</subject><subject>Host-Pathogen Interactions - drug effects</subject><subject>Humans</subject><subject>Lamivudine - therapeutic use</subject><subject>Organophosphonates - therapeutic use</subject><subject>Research Paper</subject><subject>Thymidine - analogs & derivatives</subject><subject>Thymidine - therapeutic use</subject><subject>Virus Activation - drug effects</subject><issn>1949-2553</issn><issn>1949-2553</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctu1DAUjRAVrUr3rJCXZZHWj7zMAomOgCJV6qJlbd041xNDEgfbmVH-iY_EQ0sp3tiyz8v3ZNkbRi9YUwl-6SbtIvgtxotG0vpFdsJkIXNeluLls_NxdhbCd5pWWdQNl6-yY14zzgRnJ9mvuzVEHCFaTTzuLO7J3saeTBj3zv8gI0bIYYJhDTa8Jxs3zuATeocEjbEa9EqcIc7DQKZFD-jCeXxnOyQHktsuGIhxnsQeyZwMcIrWTQeK7nF06drDvOZ26haNHelxTuLRBnJFdtYvIYUCnezgQHudHRkYAp497qfZt8-f7jfX-c3tl6-bjze5FmUR807XNcOulkLTSkrJRAMtpBGBpK0BZgqU2HZaS6SV5qaoWEuN6bq2bI1kXJxmHx5056UdsdMpdPqfmr0dwa_KgVX_v0y2V1u3UyUtm5rWSeD8UcC7n2kEUY02aBwGmNAtQbGGVZWgJW8SlD5AtXcheDRPNoyqPz2rfz2rQ8-J8vZ5vCfC31bFb51rrjs</recordid><startdate>20160524</startdate><enddate>20160524</enddate><creator>Zhang, Min-Yue</creator><creator>Zhu, Gui-Qi</creator><creator>Shi, Ke-Qing</creator><creator>Zheng, Ji-Na</creator><creator>Cheng, Zhang</creator><creator>Zou, Zhuo-Lin</creator><creator>Huang, Hong-Hui</creator><creator>Chen, Fang-Yuan</creator><creator>Zheng, Ming-Hua</creator><general>Impact Journals LLC</general><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><scope>5PM</scope></search><sort><creationdate>20160524</creationdate><title>Systematic review with network meta-analysis: Comparative efficacy of oral nucleos(t)ide analogues for the prevention of chemotherapy-induced hepatitis B virus reactivation</title><author>Zhang, Min-Yue ; Zhu, Gui-Qi ; Shi, Ke-Qing ; Zheng, Ji-Na ; Cheng, Zhang ; Zou, Zhuo-Lin ; Huang, Hong-Hui ; Chen, Fang-Yuan ; Zheng, Ming-Hua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-dc771ed793c06999138aba890a90bfa1f4e9ebdcc9e06c2f461b0ffddb5bf9123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenine - analogs & derivatives</topic><topic>Adenine - therapeutic use</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Controlled Clinical Trials as Topic</topic><topic>Guanine - analogs & derivatives</topic><topic>Guanine - therapeutic use</topic><topic>Hepatitis B - chemically induced</topic><topic>Hepatitis B - prevention & control</topic><topic>Hepatitis B - virology</topic><topic>Hepatitis B virus - drug effects</topic><topic>Hepatitis B virus - physiology</topic><topic>Host-Pathogen Interactions - drug effects</topic><topic>Humans</topic><topic>Lamivudine - therapeutic use</topic><topic>Organophosphonates - therapeutic use</topic><topic>Research Paper</topic><topic>Thymidine - analogs & derivatives</topic><topic>Thymidine - therapeutic use</topic><topic>Virus Activation - drug effects</topic><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Min-Yue</creatorcontrib><creatorcontrib>Zhu, Gui-Qi</creatorcontrib><creatorcontrib>Shi, Ke-Qing</creatorcontrib><creatorcontrib>Zheng, Ji-Na</creatorcontrib><creatorcontrib>Cheng, Zhang</creatorcontrib><creatorcontrib>Zou, Zhuo-Lin</creatorcontrib><creatorcontrib>Huang, Hong-Hui</creatorcontrib><creatorcontrib>Chen, Fang-Yuan</creatorcontrib><creatorcontrib>Zheng, Ming-Hua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Oncotarget</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Min-Yue</au><au>Zhu, Gui-Qi</au><au>Shi, Ke-Qing</au><au>Zheng, Ji-Na</au><au>Cheng, Zhang</au><au>Zou, Zhuo-Lin</au><au>Huang, Hong-Hui</au><au>Chen, Fang-Yuan</au><au>Zheng, Ming-Hua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review with network meta-analysis: Comparative efficacy of oral nucleos(t)ide analogues for the prevention of chemotherapy-induced hepatitis B virus reactivation</atitle><jtitle>Oncotarget</jtitle><addtitle>Oncotarget</addtitle><date>2016-05-24</date><risdate>2016</risdate><volume>7</volume><issue>21</issue><spage>30642</spage><epage>30658</epage><pages>30642-30658</pages><issn>1949-2553</issn><eissn>1949-2553</eissn><abstract>Currently, no consensus exists regarding the optimal oral prophylactic regimens for hepatitis B surface antigen seropositive patients undergoing chemotherapy. We aimed to compare the efficacy of oral nucleos(t)ide analogues (NAs), including lamivudine, entecavir, adefovir, telbivudine and tenofovir, for the prevention of chemotherapy-induced hepatitis B virus (HBV) reactivation and its related morbidity and mortality in patients with chronic HBV (CHB) infection.
Fifty-two eligible articles consisting of 3892 participants were included. For HBV reactivation, prophylactic treatment with NAs were all significantly superior to no prophylaxis, with odds ratio (OR) from 0.00 (95% confidence interval [CI] 0.00~0.04) for the most effective intervention (tenofovir) to 0.10 (95% CI 0.06~0.14) for the least effective intervention (lamivudine). For secondary outcomes, prophylaxis with NAs also significantly outperformed observation. The results suggested that entecavir reduced the risk of HBV related hepatitis (predicted probability, 83%), HBV related death (68%) and all causes of hepatitis (97%) most efficaciously. It ranked second in decreasing all causes of death (34%).
PubMed, Embase and Cochrane Library database were searched for controlled trials up to March 31, 2015. Primary outcome was the incidence of HBV reactivation. Secondary outcomes included the incidence of HBV-related hepatitis and death, all causes of hepatitis and death. Network meta-analysis combined direct and indirect evidence to estimate ORs for the clinical outcomes. A mean ranking and the probability of optimal therapeutic regime was obtained for each treatment based on clinical outcomes.
Available evidence suggests that prophylatic therapy with tenofovir and entecavir may be the most potent interventions in prevention of HBV reactivation and HBV-related morbidity and mortality for CHB infection patients undergoing chemotherapy.</abstract><cop>United States</cop><pub>Impact Journals LLC</pub><pmid>27121321</pmid><doi>10.18632/oncotarget.8907</doi><tpages>17</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adenine - analogs & derivatives Adenine - therapeutic use Antineoplastic Agents - adverse effects Antiviral Agents - therapeutic use Controlled Clinical Trials as Topic Guanine - analogs & derivatives Guanine - therapeutic use Hepatitis B - chemically induced Hepatitis B - prevention & control Hepatitis B - virology Hepatitis B virus - drug effects Hepatitis B virus - physiology Host-Pathogen Interactions - drug effects Humans Lamivudine - therapeutic use Organophosphonates - therapeutic use Research Paper Thymidine - analogs & derivatives Thymidine - therapeutic use Virus Activation - drug effects |
title | Systematic review with network meta-analysis: Comparative efficacy of oral nucleos(t)ide analogues for the prevention of chemotherapy-induced hepatitis B virus reactivation |
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