Lamivudine plus adefovir combination therapy versus entecavir monotherapy for lamivudine-resistant chronic hepatitis B: a systematic review and meta-analysis
2011

Combination Therapy for Lamivudine-Resistant Chronic Hepatitis B

Sample size: 451 publication 10 minutes Evidence: moderate

Author Information

Author(s): Sheng Yun-Jian, Liu Jun-Ying, Tong Shi-Wen, Hu Huai-Dong, Zhang Da-Zhi, Hu Peng, Ren Hong

Primary Institution: The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Hypothesis

Is lamivudine plus adefovir combination therapy more effective than entecavir monotherapy for treating lamivudine-resistant chronic hepatitis B?

Conclusion

LAM plus ADV combination therapy was more effective and produced longer-lasting effects than switching to ETV monotherapy in treating CHB patients with LAM resistance.

Supporting Evidence

  • Combination therapy produced faster and greater HBV DNA reduction rates 24 weeks post therapy compared to ETV monotherapy.
  • The rate of virologic breakthrough was higher in the ETV group than in the LAM plus ADV group.
  • ALT normalization rates were similar between both treatment groups.

Takeaway

This study found that using two medicines together is better than just one for people with a certain type of hepatitis B that doesn't respond to the usual treatment.

Methodology

A systematic review and meta-analysis of six trials comparing LAM plus ADV combination therapy to ETV monotherapy.

Potential Biases

Potential for publication bias and variability in study quality.

Limitations

Some studies were not RCTs, had small sample sizes, and publication bias may have affected results.

Participant Demographics

Patients with chronic hepatitis B and lamivudine resistance.

Statistical Information

P-Value

0.003

Confidence Interval

95%CI (0.18, 0.71)

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1743-422X-8-393

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