Entecavir for Patients with Hepatitis B Decompensated Cirrhosis in China: a meta-analysis.
Evidence about the clinical effects of entecavir (ETV) for patients with hepatitis B decompensated cirrhosis remain controversial. Therefore, we perform this meta-analysis to assess the treatment outcomes of ETV in participants with hepatitis B decompensated cirrhosis. Relevant studies were identified by searching databases until the March 2016. A random-effects model was used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). GRADEprofiler3.6 was used to evaluate the quality of the evidence. A total of 26 studies (involving 2040 patients) were included. The quality of the evidence was classified from very low to high by the GRADED approach for all included RCTs. Meta-analysis showed that patients were more likely to experience HBV-DNA loss (RR:1.85, 95%CIs: 1.41 to 2.43, P < 0.0001 at 48 weeks), have normalized alanine aminotransferase levels (ALT) (P = 0.003 at 24 weeks, P = 0.02 at 48 weeks), and have a low mortality rate at 24 weeks (P = 0.003) when treated with ETV. There was no significant different between ETV and the control groups at the total mortality (P = 0.06) and HBeAg seroconversion (P = 0.14). In conclusion, ETV could be the first line therapy for patients with HBV related decompensated cirrhosis, because ETV could reduce the early mortality and move HBV DNA load down.
Shandong University, Shandong, 250100, China.
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Wang
Department of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Shandong, 250021, China.
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Li
Department of Intensive care unit, Qilu hospital affiliated to Shandong University, Shandong, 250012, China.
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Li
Department of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Shandong, 250021, China.
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Liu
Department of Health, the Central Hospital of Tai'an, Shandong, 271000, China.
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Qu
Department of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Shandong, 250021, China.
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Xu
Central laboratory, Shandong Province Hospital Affiliated to Shandong University, Shandong, 250021, China.
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Qi
Department of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Shandong, 250021, China.
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Qin
D000998:Antiviral Agents / Q000627:therapeutic use*; D002681:China; D004279:DNA, Viral / Q000235:genetics; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy*
D000998:Antiviral Agents; D004279:DNA, Viral; C413685:entecavir; D006147:Guanine