Evidence map›Paper›PMID 32277491›Full record

SynthesisHepatology (Baltimore, Md.)2021

Comparative Effectiveness of Entecavir Versus Tenofovir for Preventing Hepatocellular Carcinoma in Patients with Chronic Hepatitis B: A Systematic Review and Meta-Analysis.

Shravan Dave, Sooyoung Park, M Hassan Murad, Abbey Barnard, Larry Prokop, Leon A Adams, Siddharth Singh, Rohit Loomba

Open access · greenAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 6 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 6 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Review
  8. Article
  9. [Research advances in occurrence risk assessment and early-stage diagnosis of hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Review
  10. Article
  11. [Strategies of statins for the prevention and treatment of hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Shravan DaveDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA.
Sooyoung ParkDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA.
M Hassan MuradDivision of Preventive Medicine, Mayo Clinic, Rochester, MN.
Abbey BarnardDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA.
Larry ProkopDivision of Library Sciences, Mayo Clinic, Rochester, MN.
Leon A AdamsMedical School, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA.
Rohit LoombaDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA.
University of California, San Diego · USMayo Clinic · USMayo Clinic in Arizona · USUniversity of Western Australia · AU

Funding

Comparative Risks and Benefits of Pharmacological Therapies for Older Patients with Inflammatory Bowel DiseasesK23DK117058 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SINGH, SIDDHARTH · 2018 to 2022
$971k
NIDDK NIH HHS K23 DK117058
6 · The paper itself

Abstract

BACKGROUND AND

aimsChronic hepatitis B (CHB) can lead to hepatocellular carcinoma (HCC). While both tenofovir disoproxil (TDF) and entecavir (ETV) have been shown to reduce the risk of HCC, their comparative effectiveness is unclear. We estimated the comparative effectiveness of these two agents in reducing the risk of HCC in patients with CHB, through a systematic review and meta-analysis. APPROACH AND

resultsWe searched multiple electronic databases from January 1, 1998, to October 31, 2019, for randomized controlled trials and observational comparative effectiveness studies in adults with CHB treated with ETV compared to TDF, reporting the incidence of HCC (minimum follow-up 12 months). Primary outcome was incidence of HCC, calculated as incidence rate ratio (IRR) with 95% confidence interval (CI, unadjusted analysis) and hazard ratio (HR) with 95% CI (adjusted analysis, where reported). Of 1,971 records identified, 14 studies (263,947 person-years) were included for quantitative analysis. On unadjusted meta-analysis of 14 studies, the risk of HCC was not statistically different between ETV and TDF (IRR, 1.28; 95% CI, 0.99-1.66). When using available adjusted data (multivariate or propensity-matched data), the risk of HCC among patients treated with ETV was 27% higher when compared to TDF (seven studies; 95% CI, 1.01-1.60, P = 0.04). Additional analysis of adjusted data when separately reported among patients with cirrhosis demonstrated an adjusted HR of 0.90 (95% CI, 0.66-1.23), suggesting no difference between ETV-treated and TDF-treated groups. The overall confidence in estimates was very low (observational studies, high heterogeneity).

conclusionsTDF may be associated with lower risk of HCC when compared to ETV.

Indexed as

Antiviral AgentsCarcinoma, HepatocellularGuanineHepatitis B, ChronicHumansIncidenceLiver CirrhosisLiver NeoplasmsObservational Studies as TopicRandomized Controlled Trials as TopicRiskTenofovirAntiviral AgentsentecavirGuanineTenofovir

Identifiers

PMID32277491
PMCPMC8022893
OpenAlexW3015207295

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.