Evidence map›Paper›PMID 42076967›Full record

ArticleAlimentary pharmacology & therapeutics2026

Superior Efficacy of Tenofovir Alafenamide Compared With Entecavir in Reducing Hepatitis B Surface Antigen: A Multicentre Propensity Score-Matched Study Using Linear Mixed-Effects Models.

Takashi Kumada, Masanori Atsukawa, Norio Itokawa, Taeang Arai, Hidenori Toyoda, Akihito Tsubota, Tsunamasa Watanabe, Makoto Chuma, Kentaro Matsuura, Atsushi Hiraoka and 12 more

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

22 authors.

Takashi KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.ORCID https://orcid.org/0000-0003-2211-495X
Masanori AtsukawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.ORCID https://orcid.org/0000-0003-3374-7111
Norio ItokawaDivision of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan.ORCID https://orcid.org/0009-0002-2390-6692
Taeang AraiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.ORCID https://orcid.org/0009-0008-5817-1845
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.ORCID https://orcid.org/0000-0002-1652-6168
Akihito TsubotaResearch Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0001-6860-0326
Tsunamasa WatanabeDepartment of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.ORCID https://orcid.org/0000-0002-7659-914X
Makoto ChumaGastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.ORCID https://orcid.org/0000-0002-0963-9172
Kentaro MatsuuraDepartment of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.ORCID https://orcid.org/0009-0005-0163-3971
Atsushi HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.ORCID https://orcid.org/0000-0003-1989-0480
Toshifumi TadaDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.ORCID https://orcid.org/0000-0002-0976-6761
Koichi TakaguchiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Tokyo, Kagawa, Japan.ORCID https://orcid.org/0000-0003-0175-8721
Keizo KatoDivision of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Matsudo, Japan.
Hiroshi AbeDivision of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Matsudo, Japan.
Joji TaniDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan.ORCID https://orcid.org/0000-0001-8801-2505
Toru IshikawaDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.ORCID https://orcid.org/0000-0002-5470-9694
Chikara OgawaDepartment of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan.ORCID https://orcid.org/0000-0002-4534-6692
Toru AsanoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.ORCID https://orcid.org/0000-0002-1148-1634
Tsunekazu OikawaDepartment of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0003-1365-5391
Yoshihiro MatsumotoDepartment of Gastroenterology and Hepatology, Jikei University School of Medicine Kashiwa Hospital, Kashiwa, Japan.
Tomoyuki AkitaDepartment of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.ORCID https://orcid.org/0000-0002-1056-3611
Junko TanakaDepartment of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.ORCID https://orcid.org/0000-0002-5669-4051

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsEntecavir and tenofovir alafenamide fumarate are potent nucleos(t)ide analogues used to treat chronic hepatitis B; however, their differential effects on hepatitis B surface antigen expression decline remain unclear. In this multicentre study, we aimed to examine the hepatitis B surface antigen-reducing effects.

methodsTreatment-naïve chronic hepatitis B patients who received entecavir (n = 491) or tenofovir alafenamide fumarate (n = 463) were enrolled. After 1:1 propensity score matching for sex, baseline hepatitis B surface antigen, hepatitis B e-antigen status, hepatitis B virus deoxyribonucleic acid, fibrosis-4 score, and the presence of hepatocellular carcinoma, data from 334 patients per group were analysed. Linear mixed-effects models were used to assess longitudinal changes over 4 years.

resultsTenofovir alafenamide fumarate was associated with a greater decline in hepatitis B surface antigen compared to entecavir, with significant differences at 1, 3, and 4 years. Its superiority was most pronounced in patients aged < 65 years, those without cirrhosis, those with baseline hepatitis B surface antigen ≥ 3.0 log IU/mL, those with either negative or positive hepatitis B e-antigen, and those with baseline hepatitis B virus deoxyribonucleic acid < 4.4 log IU/mL. Both treatments achieved comparable virological suppression and alanine aminotransferase normalisation. The estimated glomerular filtration rate showed a transient decline with tenofovir alafenamide fumarate in year 1, which subsequently diminished and may partly reflect the inhibition of tubular creatinine secretion.

conclusionsThis evidence supports personalised treatment selection for functional cure.

trial registrationThe UMIN Clinical Trials Registry 000034362.

Indexed as

AdenineAntiviral AgentsGuanineHepatitis B, ChronicHepatitis B Surface AntigensTenofovirAdultAgedAlanineFemaleHumansMaleMiddle AgedPropensity ScoreTreatment OutcomeAdenineAlanineAntiviral AgentsentecavirGuanineHepatitis B Surface AntigensTenofovirtenofovir alafenamidechronic hepatitis Bentecavirhepatitis B surface antigenmixed‐effects modelpropensity score matchingsubgroup analysistenofovir alafenamide

Identifiers

PMID42076967
PMCPMC13356428

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Registered trials

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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.