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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Entecavir plus adefovir combination therapy versus lamivudine add-on adefovir for lamivudine-resistant chronic hepatitis B: A meta-analysis
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Entecavir plus adefovir combination therapy versus lamivudine add-on adefovir for lamivudine-resistant chronic hepatitis B: A meta-analysis

机译：Entecavir Plus Adefovir组合疗法与拉米夫定抗性慢性乙型肝炎的拉米夫定加载体Adefovir：Meta分析

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摘要

To determine whether adefovir (ADV) in combination with entecavir (ETV) is more effective than with lamivudine (LAM) in patients with lamivudine-resistant chronic HBV infection, electronic databases were searched through May 10th, 2013 to obtain relevant trials which met the inclusion criteria. Meta-analysis was performed on randomized controlled trials (RCTs) and non-randomized studies. Four trials containing a total of 323 patients were included. Serum HBV DNA reductions after 3 and 6 months of treatment in the ETV+ADV group were greater than that of LAM+ADV group (mean difference (MD)=0.90, 95% confidence interval (CI): 0.74-1.07, P<0.00001; MD=0.81, 95% CI: 0.57-1.06, P<0.00001). The rate of 6 months HBV DNA undetectability with ETV and ADV was higher than that of LAM and ADV (relative risk (RR)=1.63, 95% CI: 1.14-2.34, P<0.007). There were higher rates of serum ALT normalization than those in LAM+ADV group after 6 months of treatment (RR=1.40, 95% CI: 1.11-1.77, P<0.005). The ETV+ADV group had lower viral breakthrough and genotypic mutation rates than LAM+ADV group after 12 months of treatment (RR=0.24, 95% CI: 0.10-0.58, P=0.002). The combination of ETV plus ADV is a more effective rescue therapy than LAM add-on ADV in patients with LAM-resistant HBV.
机译：为了确定Adefovir（ADV）是否与Entecavir（ETV）组合的比Lamivudine（LAM）与拉米夫定慢性HBV感染患者更有效，通过2013年5月10日搜查了电子数据库，以获得符合纳入的相关试验标准。对随机对照试验（RCTS）和非随机性研究进行了META分析。包含共有323名患者的四次试验。在ETV + ADV组的治疗3和6个月后血清HBV DNA减少大于LAM + ADV组（平均差（MD）= 0.90,95％置信区间（CI）：0.74-1.07，P <0.00001 ; MD = 0.81,95％CI：0.57-1.06，P <0.00001）。 HBV DNA与ETV和ADV的率为6个月的速率高于LAM和ADV（相对风险（RR）= 1.63,95％CI：1.14-2.34，P <0.007）。 6个月治疗后，血清ALT标准化的血清ALT标准化率较高（RR = 1.40,95％CI：1.11-1.77，P <0.005）。在处理12个月后，ETV + ADV组的病毒突破和基因型突变率比LAM + ADV组（RR = 0.24,95％CI：0.10-0.58，P = 0.002）。 ETV Plus ADV的组合是含有脉冲HBV患者的LAM附加副副总署的更有效的救援治疗。

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