Efficacy and safety of Tenofovir disoproxil fumarate (TDF) or Entecavir (ETV) combined with interferon for the treatment of chronic hepatitis B: a systematic review and meta-analysis.

What was studied

This review pooled trials in long-term hepatitis B. It tested tenofovir (TDF) or entecavir (ETV) added to interferon. Each was compared with the same drug alone. The review covered 16 randomized trials with 2,575 patients. Main outcomes were a drop in HBsAg and HBeAg seroconversion.

What they found

TDF plus interferon lowered HBsAg more than TDF alone. The odds ratio was 5.16. ETV plus interferon showed no clear gain over ETV alone. Its odds ratio was 1.16. HBeAg seroconversion also favored regimens with TDF. HBV DNA negativity improved overall, but only with TDF regimens. Safety data varied too much to pool. No steady extra harm was seen, but certainty was very low.

What it means for patients

The authors say TDF-based combos were linked to a better outcome than ETV-based ones. They say TDF may be a base option for patients seeking HBsAg loss. They say ETV combos remain an alternative. They stress the findings describe results and do not give firm treatment advice.

Why it is not certain yet

Certainty was moderate for blood marker results. It was low for HBV DNA and very low for safety. The trials were mostly in HBeAg-positive Asian groups. The authors say results should not be applied to other groups. No trial was blinded. The safety data cannot rule out kidney or bone harm.

Source

Efficacy and safety of Tenofovir disoproxil fumarate (TDF) or Entecavir (ETV) combined with interferon for the treatment of chronic hepatitis B: a systematic review and meta-analysis.

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