摘要
Abstract
Objective To compare the efficacy and safety of nucleos (t)ide analogue monotherapy for treatment of naive patients with chronic hepatitis B. Methods A systematic review of related databases was conducted to evaluate the efficacy and safety of nucleos (t)ides in adult patients with chronic hepatitis B (CHB). Only randomized controlled trials were included. The evaluated outcomes included undetectable HBV DNA,ALT normalization,HBeAg loss and HBeAg seroconversion at the end of 1 year treatment. Stata13 was applied to perform this network Meta-analysis. Results In 14 RCTs included,a total of 5720 patients with CHB were recruited,and out of them,1396 cases were treated with ETV,982 with LdT,2015 with LAM,783 with TDF,and 544 with ADV. As respect to undetectable serum HBV DNA,the sucra values of five agents were as follows:TDF(88.5%),ETV(79.9%),LdT(55.4%),LAM(19.9%) and ADV(6.2%);As for ALT normalization,the sucra values were as follows:ETV (95.9%),TDF (56.6%),LdT (44.6%),ADV (34.1%)and LAM (18.8%);for HBeAg loss,the sucra values were as follows:LdT(80.2%),TDF(76.2%),ETV(42.5%),LAM(27.4%) and ADV (23.7%);for HBeAg seroconversion,the sucra values were as follows:LdT (79.9%),TDF (66.5%),ETV (39.1%),LAM (35.5%)and ADV (29.0%). Conclusion TDF is the best in undectable serum HBV DNA,ETV is the best in ALT normalization and LdT is the best in HBeAg loss and/or HBeAg seroconversion.关键词
慢性乙型肝炎/核苷(酸)类似物/网络Meta分析/疗效Key words
Hepatitis B/Nucleos(t)ides/Network Meta analysis/Efficacy
