TDF better than entecavir at reducing HCC risk, improving survival in CHB patients

Tenofovir disoproxil fumarate (TDF) appears to provide a lower risk of hepatocellular carcinoma (HCC) development and longer survival in patients with chronic hepatitis B (CHB) than entecavir, particularly among treatment-naïve patients and those with underlying cirrhosis, reveals a study.

The investigators examined the comparative effectiveness of TDF vs entecavir in reducing the risk of HCC development. They searched the Medline database through 13 April 2020 for studies involving CHB treated with TDF and/or entecavir.

The incidence of HCC and overall survival, calculated as risk ratios (RRs), were the primary and secondary outcomes, respectively. The investigators adjusted and further evaluated the results by pooling propensity score matched cohorts.

A total of 229 records were identified, of which 17 were included in the quantitative analysis. TDF correlated with a significantly reduced risk of HCC development (RR, 0.63, 95 percent confidence interval [CI], 0.43–0.93; p=0.024) and mortality (RR, 0.69, 95 percent CI, 0.57–0.84; p=0.003) compared with entecavir.

In addition, TDF substantially reduced the risk of HCC in patients with cirrhosis (RR, 0.69, 95 percent CI, 0.56–0.84) and antiviral treatment-naïve patients (RR, 0.59, 95 percent CI, 0.35–0.98) compared with entecavir. In treatment-naïve patients, TDF treatment led to a significantly longer survival than entecavir (RR, 0.69, 95 percent CI, 0.52–0.91).

“TDF likely confers a lower risk of HCC development and longer survival in patients with CHB, especially among treatment-naïve patients and those with underlying cirrhosis, than entecavir,” the investigators said.