Chen J, et al. – The efficacy of tenofovir disoproxil fumarate (TDF) was compared with the combination therapy [TDF plus entecavir (ETV)] in patients with chronic hepatitis B (CHB) with a poor response to ETV. Outcomes revealed that TDF monotherapy was comparable to TDF–ETV combination therapy for patients with a poor response to ETV. Hence, TDF monotherapy was probably a better choice for these patients. However, further research work was required to verify these results.

Methods

• The authors explored the China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, and SCOPE libraries for articles using the keywords chronic hepatitis B virus or CHB or HBV, entecavir or ETV, and tenofovir or TDF.

Results

• 5 studies (from CNKI and PubMed) with a total of 408 patients met the inclusion criteria: 212 patients in the TDF group and 196 patients in the TDF plus ETV group.
• Between the 2 groups, the rates of viral suppression were comparable at weeks 24 and 48 of treatment (P = 0.546 vs P = 0.818).
• Moreover, the subanalysis revealed that no significant differences were reported in the rates of viral suppression between the 2 groups at week 24 (subgroup 1 [partial response to ETV]: P = 0.822; subgroup 2 [resistance to ETV]: P = 0.294) and week 48 (subgroup 1: P = 0.797; subgroup 2: P = 0.545).
• Between the 2 groups at weeks 24 and 48, no significant differences were found in alanine aminotransferase normalization, hepatitis B e antigen loss, hepatitis B e antigen seroconversion, virologic breakthrough, and tolerability.
• These findings indicated that TDF monotherapy should be chosen for patients with CHB with a poor response to ETV for reasons of economy and convenience.