Authors:
Address: Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Journal:

Publication:

abstract

BACKGROUND:

lamivudine has been widely used in chronic hepatitis B patients with hepatic decompensation, but its use is limited by drug resistance. This outcome research aimed to investigate the comparative efficacy and safety of Entecavir versus lamivudine in decompensated patients.

METHODS:

Between November 2004 and February 2010, 126 consecutive treatment-naive patients received either entecavir (n=53) or lamivudine (n=73) for decompensated chronic hepatitis B. All patients presented with both hyperbilirubinaemia and coagulopathy. Primary outcome was mortality within 1 year; secondary outcomes included liver-related mortality, biochemical and virological response, and improvement of hepatic dysfunction.

RESULTS:

Both treatment groups were comparable in baseline characteristics. A total of 19 (35.8%) entecavir and 33 (45.2%) lamivudine receivers expired within 1 year, respectively (P=0.29, log rank test). Age (hazard ratio [HR] 1.04 per year, 95% CI 1.01, 1.06), cirrhosis (HR 2.07, 95% CI 1.02, 4.23), and international normalized ratio for prothrombin time (HR 1.44, 95% CI 1.20, 1.74) were independent baseline predictors for all-cause mortality. Antiviral therapy was also unrelated to liver-specific death. However, more patients taking entecavir tended to attain aminotransferase normalization (76.5% versus 52.5%; P=0.05) and viral DNA undetectability (100% versus 58.3%; P=0.06). Moreover, entecavir was associated with significantly greater reduction of the model for end-stage liver disease scores (median 10.0 versus 4.3; P=0.02). Overall, 3 (7.5%) lamivudine but no entecavir users acquired drug resistance in 1 year (P=0.25).

CONCLUSIONS:

Entecavir as compared with lamivudine is similar in the effect on short-term mortality but is associated with greater clinical improvement among chronic hepatitis survivors who recovered from hepatic decompensation.

Related Articles
Efficacy and safety of entecavir versus adefovir in chronic hepatitis B patients with hepatic decompensation: a randomized, open-label study.
Hepatology. 2011
Efficacy and safety of entecavir versus adefovir in chronic hepatitis B patients with hepatic decompensation: a randomized, open-label study.
Liaw YF, Raptopoulou-Gigi M, Cheinquer H, Sarin SK, Tanwandee T, Leung N, Peng CY, Myers RP, Brown RS Jr, Jeffers L, et al. Hepatology. 2011 Jul; 54(1):91-100.
Evaluation of the cost-effectiveness of entecavir versus lamivudine in hepatitis BeAg-positive chronic hepatitis B patients.
J Manag Care Pharm. 2008
Evaluation of the cost-effectiveness of entecavir versus lamivudine in hepatitis BeAg-positive chronic hepatitis B patients.
Yuan Y, Iloeje UH, Hay J, Saab S. J Manag Care Pharm. 2008 Jan-Feb; 14(1):21-33.
Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B.
N Engl J Med. 2006
Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B.
Lai CL, Shouval D, Lok AS, Chang TT, Cheinquer H, Goodman Z, DeHertogh D, Wilber R, Zink RC, Cross A, et al. N Engl J Med. 2006 Mar 9; 354(10):1011-20.
Review Management of chronic hepatitis B.
Evid Rep Technol Assess (Full ...
Review Management of chronic hepatitis B.
Wilt TJ, Shamliyan T, Shaukat A, Taylor BC, MacDonald R, Yuan JM, Johnson JR, Tacklind J, Rutks I, Kane RL. Evid Rep Technol Assess (Full Rep). 2008 Oct; (174):1-671.
Review Cross-study analysis of the relative efficacies of oral antiviral therapies for chronic hepatitis B infection in nucleoside-naive patients.
Clin Drug Investig. 2007
Review Cross-study analysis of the relative efficacies of oral antiviral therapies for chronic hepatitis B infection in nucleoside-naive patients.
Dienstag JL, Wei LJ, Xu D, Kreter B. Clin Drug Investig. 2007; 27(1):35-49.

To top • Home

---

Show map | Diseases | Vaccination | Chronic disease | Medicine | Pregnancy | Heat & Sunburn | Cold | Security | Useful tips | Faq | News

TraveldoctorOnline 2001 • Disclaimer • webmaster