- Entecavir and tenofovir have similar efficacy in reducing the risk for hepatocellular carcinoma (HCC).
Why this matters
- The choice between entecavir and tenofovir should be made based on cost and tolerability rather than efficacy in prevention of HCC.
- Meta-analysis of 31 studies (N=119,053).
- Funding: E-DA Hospital.
- 5-year incidence of HCC was 5.97% for entecavir (28 studies, n=86,855) and 3.06% for tenofovir (13 studies, n=28,946; P<.0001>
- In 8 studies that conducted propensity-score matching, the 5-year cumulative incidence of HCC was 3.44% for entecavir (n=19,702) and 3.39% for tenofovir (n=16,266; P=.87).
- A meta-analysis of 14 comparative studies found no significant difference between tenofovir and entecavir with respect to HCC risk (HR, 0.88; P=.20).
- The studies had significant heterogeneity (I2=56.4%; P=.0038).
- A subanalysis of hospital-based cohorts showed no difference between the 2 regimens (adjusted HR, 1.03; 95% CI, 0.88-1.21; I2=0%).
- Tenofovir was associated with lower risk for HCC among studies that used administrative databases (HR, 0.67; 95% CI, 0.59-0.76; I2=0%).
- All studies were observational.
- Many of the studies involved participants of Asian ancestry.