Entecavir and tenofovir reduce the risk of liver cancer, which one is stronger?
Tenofovir-treated patients with chronic hepatitis B had a lower risk of hepatocellular carcinoma (HCC) than entecavir-treated patients, according to a nationwide study in South Korea.
Dr. Young-SukLim of Ulsan University School of Medicine in Seoul, South Korea said: "The risk of developing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B is about 1%. Once HCC is diagnosed, the overall prognosis of patients is very poor, and the 5-year survival rate is low. less than 30%. Therefore, prevention of HCC to reduce its risk is crucial for patients with chronic hepatitis B."
Entecavir and tenofovir (TDF), both first-line antiviral agents for the treatment of chronic hepatitis B infection, have similar efficacy in terms of intermediate-term virological, biochemical, serological, and histological outcomes.
The research team used data from the Korean National Health Insurance Service to compare the effects of entecavir and tenofovir on reducing the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B.
During the follow-up period, the incidence of HCC in the tenofovir group (0.64/100 person-years) was significantly lower than that in the entecavir group (1.06/100 person-years).
In a propensity score-matched analysis, there was a difference in HCC risk between the two groups after two years of follow-up, with a 38% risk reduction in the tenofovir group.
Multivariate analysis showed that the annual incidence of all-cause mortality or liver transplantation in the tenofovir group was reduced by 23%; by propensity score matching analysis, the tenofovir group was reduced by 21%, both of which were significantly different.
In the validation cohort, 2701 patients with chronic hepatitis B infection were treated with entecavir or tenofovir; the virological response rate of the entecavir group (78.7%) was significantly lower than that of the tenofovir group (85.2%), Wei treatment reduced the risk of hepatocellular carcinoma (HCC) by 34%.
There were no significant differences in the risk of death or liver transplantation between the two treatment groups in the validation cohort.
The researchers concluded: "Two oral antiviral drugs for the treatment of patients with chronic hepatitis B are not equally effective in cancer prevention. Our results show that TDF is superior to entecavir, can reduce the incidence of HCC by 35%, and may reduce the incidence of HCC. It has considerable clinical significance for the prevention of HCC in patients with chronic hepatitis B."
Tenofovir alafenamide (TAF, HepBest, Vemlidy) is a powerful antiviral drug for chronic hepatitis B (HBV) patients with compensated liver disease, and it is an upgraded version of TDF.
Analysis of the advantages of TAF:
- Rapid improvement of the condition, low drug resistance
The most prominent advantage of TAF is its strong activity of inhibiting the virus, which can improve the condition quickly. And the 96-week efficacy and safety results of the TAF Phase III study showed that TAF did not find drug resistance while maintaining a high virus suppression rate. Patients previously treated with TDF maintained good virological suppression after switching to TAF.
- The dosage is small
Compared with TDF, TAF has higher plasma stability, can maintain the maximum integrity after entering the human body, and has a high utilization rate of active ingredients, TAF(25mg)≈TDF(300mg)
- Fewer side effects
Compared with TDF, TAF has almost no nephrotoxicity and better bone safety.
- Easy to take medicine
TAF does not need to be taken multiple times a day like other drugs, not to mention the need for injection treatment like interferon, just one pill a day.
- Cheap price
TAF is currently not listed in China, and the price of TAF in the United States is expensive. Patients can choose generic drugs from American Mylan Pharmaceuticals with the same efficacy, which are more than half cheaper than domestic TDF generic drugs.
This content is the copyright of Medical Companion Travel, welcome to share and reprint!
Medical Companion Travel: Find high-quality medical resources and accompany you on your recovery journey!