Clinical Efficacy of Chronic Hepatitis B Treatment for Patients with HBeAg-Positive Indirect Comparison: Indirect Comparison Meta-AnalysisN. Tantai, P. Lerdkiattikorn, U. Chaikledkaew*, T. Tanwandee, P. Weerayingyong and Y. Teerawattananon
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This study was aimed to assess the clinical efficacy in terms of HBeAg seroconversion among existing treatment options for HBeAg positive CHB patients using indirect comparison meta-analysis. A systematic review of randomized controlled trials (RCTs) of treatments for patients with HBeAg-positive CHB was performed through the Pubmed and Cochrane databases. The clinical studies were included only if they assessed the efficacy amongst the following treatment options namely i) lamivudine, ii) entecavir, iii) Telbivudine, iv) Adefovir, v) Tenofovir, vi) Pegylated interferon and vii) Palliative care. Indirect or mixed-treatment comparison meta-analysis with random effect model was employed to combine results of several studies. The meta-analysis was carried out using the WinBUGS14 software. Odds ratio (OR) and its 95% credible interval (CI) were presented. Heterogeneity test was applied for testing the variation of study outcomes between studies. There were 294 abstracts reviewed with 14 relevant RCTs included in the analysis. Based on the meta-analysis results, PEG2a yielded the best efficacy which was about five times more likely to increase HBeAg seroconversion rate (OR=5.36, 95%CI=2.17-10.46) than telbivudine (OR=4.29, 95%CI=2.05-7.68), tenofovir (OR=4.17, 95%CI=1.41-9.23), entecavir (OR=3.85, 95%CI= 1.96-6.72), lamivudine (OR=3.52, 95%CI=1.81-6.09) and adefovir (OR=3.03,95%CI=1.57-5.31). There was a significant increase in HBeAg seroconversion rate in patients with HBeAg positive CHB receiving antiviral treatment when compared with palliative care.
Keyword:
Chronic hepatitis B, Efficacy, Meta-analysis, HBeAg-positive, HBeAg-seroconverion
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