tailieunhanh - Báo cáo y học: " Comparison of the efficacy of lamivudine and telbivudine in the treatment of chronic hepatitis B: a systematic review"

Comparison of the efficacy of lamivudine and telbivudine in the treatment of chronic hepatitis B: a systematic review | Zhao et al. Virology Journal 2010 7 211 http content 7 1 211 VIROLOGY JOURNAL REVIEW Open Access Comparison of the efficacy of lamivudine and telbivudine in the treatment of chronic hepatitis B a systematic review 1 1 z 1-1 1 1 Shushan Zhao Lanhua Tang Xuegong Fan Lizhang Chen Rongrong Zhou Xiahong Dai Abstract Background Chronic viral hepatitis B remains a global public health concern. Currently several drugs such as lamivudine and telbivudine are recommended for treatment of patients with chronic hepatitis B. However there are no conclusive results on the comparison of the efficacy of lamivudine LAM and telbivudine LdT in the treatment of chronic hepatitis B. Results To evaluate the comparison of the efficacy of LAM and LdT in the treatment of chronic hepatitis B by a systematic review and meta-analysis of clinical trials we searched PUBMED from 1990 to April 2010 Web of Science from 1990 to April 2010 EMBASE from 1990 to April 2010 CNKI National Knowledge Infrastructure from 1990 to April 2010 VIP database from 1990 to April 2010 WANFANG database from 1990 to April 2010 the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Review. At the end of one-year treatment LdT was better than LAM at the biochemical response virological response HBeAg loss therapeutic response while less than at the viral breakthrough and viral resistance but there was no significant difference in the HBeAg seroconversion and HBsAg response. LdT was better than LAM at the HBeAg seroconversion with prolonged treatment to two years. Conclusions In summary LdT was superior in inhibiting HBV replication and preventing drug resistance as compared to LAM for CHB patients. But LdT may cause more nonspecific adverse events and can lead to more CK elevation than LAM. It is thus recommended that the LdT could be used as an option for patients but adverse events for example CK elevation must be monitored. Background Chronic hepatitis B virus

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