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Original article
Comparison of tenofovir and entecavir on the risk of hepatocellular carcinoma and mortality in treatment-naïve patients with chronic hepatitis B in Korea: a large-scale, propensity score analysis
  1. Sung Won Lee1,2,
  2. Jung Hyun Kwon1,2,
  3. Hae Lim Lee1,2,
  4. Sun Hong Yoo1,2,
  5. Hee Chul Nam1,2,
  6. Pil Soo Sung1,2,
  7. Soon Woo Nam1,2,
  8. Si Hyun Bae1,2,
  9. Jong Young Choi1,2,
  10. Seung Kew Yoon1,2,
  11. Nam Ik Han1,2,
  12. Jeong Won Jang1,2
  1. 1 Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  2. 2 The Catholic University Liver Research Center, Seoul, Republic of Korea
  1. Correspondence to Dr Jeong Won Jang, Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; garden{at}catholic.ac.kr

Abstract

Objective The use of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) has led to a decrease in the incidence of hepatocellular carcinoma (HCC) and liver-related events. However, whether there is a difference between the two agents in the extent of improving such outcomes has not been clarified thus far. Therefore, we aimed to compare TDF and ETV on the risk of HCC and mortality.

Design A total of 7015 consecutive patients with CHB who were treated with TDF or ETV between February 2007 and January 2018 at the liver units of the Catholic University of Korea were screened for study eligibility and 3022 patients were finally analysed. Study end points were HCC and all-cause mortality or liver transplantation (LT) within 5 years after the initiation of antiviral therapy. Propensity score matching (PSM) and inverse probability of treatment weighting methods were used.

Results No difference was observed between TDF and ETV in the incidence rates of HCC in the entire cohort (HR 1.030; 95% CI 0.703 to 1.509, PSM model, p=0.880) and subgroups of patients with chronic hepatitis and cirrhosis. Also, no difference was observed between TDF and ETV in the incidence rates of all-cause mortality or LT in the entire cohort (HR 1.090; 95% CI 0.622 to 1.911, PSM model, p=0.763), and patients with chronic hepatitis and cirrhosis.

Conclusion This study has demonstrated the clinical outcomes in patients with CHB who received TDF or ETV treatment. There was no difference in the intermediate-term risk of HCC and mortality or LT between the two drugs.

  • tenofovir
  • entecavir
  • hepatocellular carcinoma
  • hepatitis B

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Footnotes

  • SWL and JHK contributed equally.

  • Presented at This study was previously presented as part of a poster presentation at The International Liver Congress 2019.

  • Contributors SWL, JHK, JWJ: study concept and design, writing of the manuscript, data collection, statistical analysis and interpretation of the data. HLL, SHY, HCN, PSS: data collection and management. SWN, SHB, JYC, SKY, NIH: patient management and critical revision.

  • Funding This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2019R1A2C1009439).

  • Competing interests None declared.

  • Patient consent for publication Waiver of informed consent was obtained from the institutional review board of the Catholic University of Korea due to the retrospective nature of this study.

  • Ethics approval This study was approved by the institutional review board of the Catholic University of Korea (XC19REDI0028H).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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