HBV: HCC rates lower with TDF than entecavir

  • Choi J & al.
  • JAMA Oncol
  • 27 sept. 2018

  • de Jim Kling
  • Univadis Clinical Summaries
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • In patients with chronic HBV, tenofovir disoproxil fumarate (TDF) was associated with a lower incidence of hepatocellular carcinoma (HCC) than entecavir.

Why this matters

  • The study includes a population-based cohort as well as a validation hospital cohort.

Study design

  • Retrospective Korean study using nationwide (n=24,156; mean age, 48.9 years; 62.6% male) and hospital-based (n=2701; mean age, 48.8 years; 61.3% male) cohorts.
  • Funding: Korean government.

Key results

  • Nationwide sample (propensity-matched cohort, 10,923 pairs):
    • Propensity-score analysis showed lower risk for HCC in the TDF group (HR, 0.62; P<.001>
    • Risk for all-cause mortality or liver transplant was lower in the TDF group (HR, 0.79; P=.01).
  • Validation hospitalization cohort (propensity-matched cohort, 869 pairs):
    • VR was worse in the entecavir group overall (78.7% vs 85.2%; P<.001 and in the propensity-matched cohort vs p>
    • Propensity-score analysis adjusted for VR showed lower risk for HCC in the TDF group (HR, 0.68; P=.04).
    • There was no significant difference in risk for all-cause mortality or liver transplant.
  • In patients with cirrhosis, TDF was associated with lower HCC risk in 510 propensity score-matched pairs after adjustment for VR (HR, 0.65; P=.02).

Limitations

  • Retrospective study.
  • Korean population.