In the Journals

Patients with HBV, cirrhosis treated with entecavir experienced fewer hepatic events, deaths

Therapy with entecavir reduced the risk for hepatic events, hepatocellular carcinoma and mortality among patients with chronic hepatitis B and cirrhosis in a recent study.

Researchers evaluated outcomes in a cohort of 1,446 patients with chronic hepatitis B treated with 0.5 mg entecavir daily for 12 months or more between December 2005 and June 2012, along with a historical control cohort of 424 treatment-naive patients who received standard care. Cirrhosis was present in 482 treated and 69 control group patients. Follow-up occurred every 3 to 6 months for a mean of 36 months and 114 months in the treated and control groups, respectively.

Among treated patients, hepatic events occurred in 130 cases, and 38 patients died during follow-up, including 22 because of liver-related causes. Eighty-nine controls experienced hepatic events, with 60 deaths, 33 were liver related. Overall, no statistically significant differences were observed between groups regarding any hepatic event incidence or all-cause or liver-related mortality. Treated patients with cirrhosis had a lower 5-year cumulative probability of hepatic events compared with cirrhotic controls (25.5% vs. 45.8%; P=.001).

After adjustment for MELD score, treated patients with cirrhosis had a reduced risk for evaluated outcomes compared with cirrhotic controls, including all-cause (HR=0.34; 95% CI, 0.18-0.62) and liver-related mortality (HR=0.26; 95% CI, 0.13-0.55), hepatocellular carcinoma (HR=0.55; 95% CI, 0.31-0.99) and hepatic events (HR=0.51; 95% CI, 0.34-0.78). Treated patients with cirrhosis who did not achieve undetectable levels of HBV DNA (22% of cases) following treatment faced similar risk for hepatic events, HCC and all-cause and liver-related mortality as cirrhotic controls.

“This was one of the first large-scale, real-life cohort studies demonstrating the efficacy of entecavir therapy in reducing various complications of chronic hepatitis B,” the researchers wrote. “Patients of more advanced liver disease [who] can achieve maintained viral suppression benefit most from this antiviral therapy. Our results have provided important evidence to support the current recommendation of entecavir being one of the first-line antiviral therapies for CHB patients.”

Disclosure: See the study for a full list of relevant disclosures.

Therapy with entecavir reduced the risk for hepatic events, hepatocellular carcinoma and mortality among patients with chronic hepatitis B and cirrhosis in a recent study.

Researchers evaluated outcomes in a cohort of 1,446 patients with chronic hepatitis B treated with 0.5 mg entecavir daily for 12 months or more between December 2005 and June 2012, along with a historical control cohort of 424 treatment-naive patients who received standard care. Cirrhosis was present in 482 treated and 69 control group patients. Follow-up occurred every 3 to 6 months for a mean of 36 months and 114 months in the treated and control groups, respectively.

Among treated patients, hepatic events occurred in 130 cases, and 38 patients died during follow-up, including 22 because of liver-related causes. Eighty-nine controls experienced hepatic events, with 60 deaths, 33 were liver related. Overall, no statistically significant differences were observed between groups regarding any hepatic event incidence or all-cause or liver-related mortality. Treated patients with cirrhosis had a lower 5-year cumulative probability of hepatic events compared with cirrhotic controls (25.5% vs. 45.8%; P=.001).

After adjustment for MELD score, treated patients with cirrhosis had a reduced risk for evaluated outcomes compared with cirrhotic controls, including all-cause (HR=0.34; 95% CI, 0.18-0.62) and liver-related mortality (HR=0.26; 95% CI, 0.13-0.55), hepatocellular carcinoma (HR=0.55; 95% CI, 0.31-0.99) and hepatic events (HR=0.51; 95% CI, 0.34-0.78). Treated patients with cirrhosis who did not achieve undetectable levels of HBV DNA (22% of cases) following treatment faced similar risk for hepatic events, HCC and all-cause and liver-related mortality as cirrhotic controls.

“This was one of the first large-scale, real-life cohort studies demonstrating the efficacy of entecavir therapy in reducing various complications of chronic hepatitis B,” the researchers wrote. “Patients of more advanced liver disease [who] can achieve maintained viral suppression benefit most from this antiviral therapy. Our results have provided important evidence to support the current recommendation of entecavir being one of the first-line antiviral therapies for CHB patients.”

Disclosure: See the study for a full list of relevant disclosures.