Entecavir plus traditional Chinese medicine cuts HCC risk in CHB

Among patients with chronic hepatitis B (CHB), treatment with entecavir (ETV) and Biejia-Ruangan compound (BRC), an antifibrotic traditional Chinese medicine, helps reduce the risk of hepatocellular carcinoma (HCC), a recent study reports.

The study included 1,000 patients (median age 42.0 years, 69.9 percent men) who had just completed a 72-week study comparing ETV+BRC against ETV+placebo and entered an open-label treatment phase. Patients were followed up every 6 months, during which the primary endpoint of HCC was assessed.

In the modified intention-to-treat analysis, the researchers recorded a 7-year cumulative incidence of HCC of 4.7 percent in the BRC-treated patients. In comparison, the placebo arm saw a cumulative incidence of 9.3 percent over the same time span. The difference between groups was statistically significant (p=0.008).

Similar findings were reported for the secondary outcome of liver-related deaths. The 7-year cumulative incidence rates were 0.2 percent and 2.2 percent in the BRC and placebo arms, respectively, which corresponded to a statistically significant advantage for BRC (p=0.03).

Of note, the ETV+BRC combo demonstrated a weaker protective effect than ETV alone against HCC in those whose fibroses did not regress by 72 weeks (p=0.018).

Multivariable Cox regression analysis showed that combination treatment significantly reduced HCC risk by nearly 60 percent (hazard ratio, 0.405, 95 percent confidence interval, 0.230–0.710; p=0.002).

“While there are effective antiviral treatments that can suppress the virus in chronically infected patients, the risk of HCC remains. Herein, we show that adding a traditional Chinese medicine called Biejia-Ruangan compound to an antiviral reduced the risk of HCC in patients with chronic hepatitis B,” the researchers said.