1. Entecavir combined with interferon‐α Is superior to entecavir monotherapy in reducing hepatic and extrahepatic cancer in patients with chronic hepatitis B.
- Author
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Cheng, Kailiang, Chen, Yu, Wang, Xiaomo, Xu, Manman, Liao, Wei, Duan, Xiaoman, Zhao, Xinyu, Sun, Yuanyuan, Duan, Zhongping, and Wang, Li
- Subjects
CHRONIC hepatitis B ,HEPATITIS associated antigen ,LIVER cancer ,HEPATOCELLULAR carcinoma ,DISEASE risk factors - Abstract
Background: The objective of this study was to assess whether entecavir (ETV) in combination with interferon‐α (IFN‐α) could reduce hepatocellular cancer (HCC) and extrahepatic cancers (EHCs) in patients with chronic hepatitis B (CHB). Methods: The cohort consisted of 4194 patients with CHB treated with ETV combined with IFN‐α or ETV monotherapy at a tertiary hospital in Beijing, China, from January 2009 to December 2017. The risks, hazard ratios (HRs), and 95% confidence intervals (CIs) of HCC and EHCs were compared in the 2 groups. Results: In a multivariate Cox regression analysis, a significantly lower risk of HCC (HR, 0.6; 95% CI, 0.3‐0.9; P =.0310) and a marginally significantly lower risk of EHCs (HR, 0.2; 95% CI, 0.02‐1.3; P =.0854) were observed in the group receiving ETV combined with IFN‐α in comparison with the ETV monotherapy group. The annual virological response rates were significantly higher in the combination therapy group versus the monotherapy group (33.8% vs 21.2%; P <.0001), but the hepatitis B surface antigen (HBsAg) seroclearance rates were not (1.2% vs 0.9%; P =.8537). The HRs were consistent with propensity score–based matching, inverse probability weighting adjustments, and adjustments for virological response and HBsAg seroclearance. Conclusions: ETV combined with IFN‐α therapy is superior to ETV monotherapy in reducing the risk of HCC and EHCs for patients with CHB. People who can tolerate and benefit from IFN‐α therapy could consider combination therapy. This study finds a higher residual risk of hepatocellular cancer and extrahepatic cancers in those with entecavir monotherapy versus those with combined therapy. It is suggested that it is necessary to add interferon‐α for patients with chronic hepatitis B treated with entecavir to reduce the risk of cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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