Tenofovir bests entecavir for HCC protection in hepatitis B

In patients with chronic hepatitis B (CHB), tenofovir disoproxil fumarate (TDF) appears to perform better than entecavir (ETV) at reducing the risk of hepatocellular carcinoma (HCC) as well as improving survival, especially among those who are naïve to treatment and with underlying cirrhosis, as reported in a study.

This meta-analysis included studies comparing the impact of the two drugs on the risk of HCC in CHB patients. Of the 229 records identified, 17 studies were included in the quantitative analysis. Primary and secondary outcomes were the incidence of HCC and overall survival, respectively. Adjusted results were further evaluated by pooling propensity score-matched cohorts.

Pooled data revealed that patients treated with TDF were significantly less likely to develop HCC (risk ratio [RR], 0.63, 95 percent confidence interval [CI], 0.43–0.93; p=0.024) and die (RR, 0.69, 95 percent CI, 0.57–0.84; p=0.003) compared with those who received ETV.

Likewise, TDF was associated with a markedly lower HCC risk in the subgroups of patients with cirrhosis (RR, 0.69, 95 percent CI, 0.56–0.84) and those naïve to antiviral treatment (RR, 0.59, 95 percent CI, 0.35–0.98).

Finally, among treatment-naïve patients, TDF use resulted in a substantial increase in survival compared with ETV (RR, 0.69, 95 percent CI, 0.52–0.91).