阿德福韦酯和恩替卡韦治疗慢性乙型肝炎患者疗效的Meta分析
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- 英文论文题名：Meta analysis of efficacy of adefovir verus entecavir for treatment of chronic hepatitis B patients
- 论文作者：温晓娜 ; 王楠 ; 毛静怡 ; 刘艳萍 ; 蒋东 ; 柳丽丽 ; 孙春茗 ; 刘文生
- 英文论文作者：WEN Xiao-na ; Wang Nan ; Mao Jing-yi ; Liu Yan-ping ; Jiang Dong ; Liu Li-li ; Sun Chun-ming ; LIU Wen-sheng ; Department of Pharmacy ; The Third Central Hospital of Tianjin
- 年：2016
- 作者机构：天津市第三中心医院药剂科;
- 论文关键词：阿德福韦酯 ; 恩替卡韦 ; 慢性乙型肝炎 ; Meta分析 ; 随机对照试验
- 英文论文关键词：adefovir ; entecavir ; chronic hepatitis B ; meta-analysis ; randomized controlled trials
- 会议召开时间：2016-09-27
- 会议录名称：中国药学会第十三届青年药学科研成果交流会论文集
- 语种：中文
- 分类号：R512.62
- 学会代码：YYWS
- 会议名称：中国药学会第十三届青年药学科研成果交流会
- 会议地点：中国江西南昌
- 主办单位：中国药学会
- 学会名称：中国药学会
- 页数：8
- 文件大小：465k
- 原文格式：O
- 会议级别：全国
摘要
目的:比较阿德福韦酯(ADV)和恩替卡韦(ETV)治疗慢性乙型肝炎患者的疗效。方法:依据Cochrane协作网推荐的方法,计算机检索Medline、PubMed、Embase、Cochrane 1ibrary、CNKI全文数据库、维普中文期刊全文数据库、万方中文期刊全文数据库(建库至2013年6月)公开发表的有关ADV与ETV治疗慢性乙型肝炎患者的随机对照研究(RCTs)。按照Cochrane系统评价手册5.2版评价纳入RCT的方法学质量,采用RevMan5.2软件进行Meta分析。结果:9个随机对照试验(包括702例患者)符合纳入标准。Meta分析结果显示,ETV治疗12周、24周、48周时患者血清HBV-DNA阴转率均高于ADV组;ETV治疗24周、48周时患者血清HbeAg转阴率与ADV组差异无统计学意义;ETV治疗48周时患者HbeAg血清学转换率与ADV组差异无统计学意义;ETV治疗12周、48周时患者ALT复常率高于ADV组,24周时ETV组ALT复常率的差异无统计学意义。结论:ADV和ETV治疗慢性乙型肝炎患者,ETV组治疗后患者血清HBV DNA阴转率(12周、24周、48周)及ALT复常率(12周、48周)方面优于ADV组;但血清HbeAg转阴率(24周、48周)及HbeAg血清学转换率(48周)方面两者相似。
OBJECTIVE:To evaluate the efficacy of adefovir verus entecavir for the treatment of chronic hepatitis B patients.METHODS According to the methods recommended by the Cochrane Collaboration 5.2,randomized controlled trials(RCTs) about comparison of efficacy between adefovir and entecavir in the treatment of chronic hepatitis B patients before June 2013 were searched from Medline,PubMed,Embase,Cochrane library,CNKI,Vip,Wan Fang databases.Methodological qualities of included literatures were conducted by Cochrane.The included literatures were analyzed by the software of Rev Man 5.2.RESULTS A total of 9 RCTs(including 702 patients) met the eligible criteria.Meta analysis showed that the rate of undetected serum HBV-DNA in the group of entecavir were higher than those in the group of adefovir(12wks,24 wks,48wks),there were no statistic significances on the rates of HBeAg loss(24wks,48wks) and HBeAg seroconversion(48wks),that the rate of serum alanine aminotransferase normalization in the group of entecavir were higher than those in the group of adefovir(12wks,48wks),there were no statistic significances(24wks).CONCLUSION Entecavir was superior to adefovir in the decreasing serum HBV DNA(12wks,24 wks.48wks) and normalizing serum ALT,as for the rates of HBeAg loss and HBeAg seroconversion,the efficacies of the two drugs were similar.
OBJECTIVE:To evaluate the efficacy of adefovir verus entecavir for the treatment of chronic hepatitis B patients.METHODS According to the methods recommended by the Cochrane Collaboration 5.2,randomized controlled trials(RCTs) about comparison of efficacy between adefovir and entecavir in the treatment of chronic hepatitis B patients before June 2013 were searched from Medline,PubMed,Embase,Cochrane library,CNKI,Vip,Wan Fang databases.Methodological qualities of included literatures were conducted by Cochrane.The included literatures were analyzed by the software of Rev Man 5.2.RESULTS A total of 9 RCTs(including 702 patients) met the eligible criteria.Meta analysis showed that the rate of undetected serum HBV-DNA in the group of entecavir were higher than those in the group of adefovir(12wks,24 wks,48wks),there were no statistic significances on the rates of HBeAg loss(24wks,48wks) and HBeAg seroconversion(48wks),that the rate of serum alanine aminotransferase normalization in the group of entecavir were higher than those in the group of adefovir(12wks,48wks),there were no statistic significances(24wks).CONCLUSION Entecavir was superior to adefovir in the decreasing serum HBV DNA(12wks,24 wks.48wks) and normalizing serum ALT,as for the rates of HBeAg loss and HBeAg seroconversion,the efficacies of the two drugs were similar.
引文
[1]European Association for the study of the Liver.EASL clinical practice guidelines:management of chronic hepatitis B[J].J Hepatol,2009,50:227-242.
[2]Zoulim F,Chemin I.Hepatitis B virus induced hepatocellular carcinoma[J].Cancer Lett,2009,10(l):l-8
[3]范平,王珊.抗病毒药物的研究进展[J].医药导报,2011,30(6):732-735
[4]Zoulim F,Locamini S.Hepatitis B virus resistance to nucleos(t)ide analogues[J].Gastroenterology,2009,137(1):1593-1608
[5]赵攀,唐一平,赵沐缙,等.恩替卡韦和阿德福韦酯对HbeAg阳性慢性乙型肝炎疗效的Meta分析[J].疑难病杂志,2011,10(1)23-25
[6]Zhao P,Liu WW,Zhao J,et al.Comparison of the 48-week efficacy between,entecavir and adefovir in HBeAg-positive nucleos(t)ide-naive Asian patients with chronic hepatitis B:a meta-analysis[J].Virol J,2011,8:75-80
[7]Pin-Nan Cheng,Wen-Chun Liu,Hung-Wen Tsai,et al.Association of Intrahepatic cccDNA Reduction With the Improvement of Liver Histology in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents[J]Journal of Medical Virology,2011,83:602-607
[8]黄浩,许夕海,马泰,等.恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的随机对照研究[J].中国实用内科杂志,2010,30(6):548-549
[9]Yanfang Jiang,Wanyu Li,Lei Yu,et al.Enhancing the antihepatitis B virus immune response by adefovir dipivoxil and entecavir therapies[J].Cellular&Molecular Immunology,2011,8:75-82
[10]Nancy Leung,Cheng-Yuan Peng,Hie-Won Hann,et al.Early Hepatitis B Virus DNA Reduction in Hepatitis B e Antigen-Positive Patients with Chronic Hepatitis B:A Randomized International Study of Entecavir Versus Adefovir[J]JiEPATOLOGY,2009,49(l):72-79
[11]李纯平,魏子安,张海涛,等.恩替卡韦治疗慢性乙型肝炎近期临床研究[J].中国药房,2007,18(11):856-857
[12]林青,张大志,周智,等.恩替卡韦与阿德福韦治疗慢性乙型肝炎患者48周的临床疗效观察[J].中华肝脏病杂,2010,18(5):338-341
[13]王伟,杨方,张明香,等.ETv或ADV初治CHB患者的2年疗效观察[J].胃肠病学和肝病学杂志,2013,22(5):452-455
[141张权,程明亮,刘琴,等.恩替卡韦对核苷初治HBeAg阳性慢性乙型肝炎患者的疗效[J].世界华人消化杂志,2009,17(27):2846-2849
[15]邹顺,李雪松,李小军.阿德福韦和恩替卡韦两种抗病毒药物的疗效比较[J].中国现代医学杂[J],2010,20(9):1391-1393
[16]蒋晔,徐智儒,张晓青.抗乙肝新药阿德福韦的研究进展[J].中国新药与临床杂志,2004,23(6):373-377
[17]邹明智.恩替卡韦与阿德福韦酯抑制乙型肝炎调节性T细胞的效价差异[J].中国临床药理学与治疗学,2011,16(6):661-665
[2]Zoulim F,Chemin I.Hepatitis B virus induced hepatocellular carcinoma[J].Cancer Lett,2009,10(l):l-8
[3]范平,王珊.抗病毒药物的研究进展[J].医药导报,2011,30(6):732-735
[4]Zoulim F,Locamini S.Hepatitis B virus resistance to nucleos(t)ide analogues[J].Gastroenterology,2009,137(1):1593-1608
[5]赵攀,唐一平,赵沐缙,等.恩替卡韦和阿德福韦酯对HbeAg阳性慢性乙型肝炎疗效的Meta分析[J].疑难病杂志,2011,10(1)23-25
[6]Zhao P,Liu WW,Zhao J,et al.Comparison of the 48-week efficacy between,entecavir and adefovir in HBeAg-positive nucleos(t)ide-naive Asian patients with chronic hepatitis B:a meta-analysis[J].Virol J,2011,8:75-80
[7]Pin-Nan Cheng,Wen-Chun Liu,Hung-Wen Tsai,et al.Association of Intrahepatic cccDNA Reduction With the Improvement of Liver Histology in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents[J]Journal of Medical Virology,2011,83:602-607
[8]黄浩,许夕海,马泰,等.恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的随机对照研究[J].中国实用内科杂志,2010,30(6):548-549
[9]Yanfang Jiang,Wanyu Li,Lei Yu,et al.Enhancing the antihepatitis B virus immune response by adefovir dipivoxil and entecavir therapies[J].Cellular&Molecular Immunology,2011,8:75-82
[10]Nancy Leung,Cheng-Yuan Peng,Hie-Won Hann,et al.Early Hepatitis B Virus DNA Reduction in Hepatitis B e Antigen-Positive Patients with Chronic Hepatitis B:A Randomized International Study of Entecavir Versus Adefovir[J]JiEPATOLOGY,2009,49(l):72-79
[11]李纯平,魏子安,张海涛,等.恩替卡韦治疗慢性乙型肝炎近期临床研究[J].中国药房,2007,18(11):856-857
[12]林青,张大志,周智,等.恩替卡韦与阿德福韦治疗慢性乙型肝炎患者48周的临床疗效观察[J].中华肝脏病杂,2010,18(5):338-341
[13]王伟,杨方,张明香,等.ETv或ADV初治CHB患者的2年疗效观察[J].胃肠病学和肝病学杂志,2013,22(5):452-455
[141张权,程明亮,刘琴,等.恩替卡韦对核苷初治HBeAg阳性慢性乙型肝炎患者的疗效[J].世界华人消化杂志,2009,17(27):2846-2849
[15]邹顺,李雪松,李小军.阿德福韦和恩替卡韦两种抗病毒药物的疗效比较[J].中国现代医学杂[J],2010,20(9):1391-1393
[16]蒋晔,徐智儒,张晓青.抗乙肝新药阿德福韦的研究进展[J].中国新药与临床杂志,2004,23(6):373-377
[17]邹明智.恩替卡韦与阿德福韦酯抑制乙型肝炎调节性T细胞的效价差异[J].中国临床药理学与治疗学,2011,16(6):661-665