Objective To assess the efficacy of telbivudine in the treatment of chronic hepatitis B (CHB).
Methods Randomized controlled trials (RCTs) of telbivudine therapy vs. lamivudine therapy in both Chinese and English were retrieved from seven electronic databases with a cut-off date in February 2010, including PubMed, EMbase, VIP, CBM, CNKI, and The Cochrane library. The meta-analyses and evaluation on methodology quality were performed for the included studies. Results Two RCTs as Grade-A study were included. The meta-analyses showed that telbivudine was superior to lamivudine in aspects of therapeutic response (RR=1.28, 95%CI 1.10 to 1.48, P=0.001), ALT normalization (RR=1.12, 95%CI 1.01 to 1.23, P=0.02), and PCR-negative HBV DNA or below the lower limit (RR=1.44, 95%CI 1.36 to 1.53, P lt;0.000 01), primary treatment failure (OR=0.28, 95%CI 0.18, to 0.43, P lt;0.000 01), viral breakthrough (OR=0.38, 95%CI 0.32 to 0.47, P lt;0.000 01) and viral resistance (OR=0.44, 95%CI 0.36 to 0.55, P lt;0.000 01).
Conclusion Based on the current clinical evidence, telbivudine demonstrates superiority in comparison with lamivudine on all direct measures of antiviral efficacy for CHB. Because of the short follow-up duration and the small sample size of the included studies, it is expected to further discuss the long-term efficacy.
Citation：
ZHAN Mei,WU Fengbo,WU Bin,LIU Ruming,TANG Yao. Telbivudine in the Treatment of Chronic Hepatitis B: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(1): 101-105. doi: 10.7507/1672-2531.20110018
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Hou J, Yin YK, Xu D, et al. Telbivudine versus lamivudine in Chinese patients with chronic hepatitis B: Results at 1 year of a randomized, double-blind trial. Hepatology, 2008, 47(2): 447-454.
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Jia JD, Hou JL, Yin YK, et al. Two-year results of a phase III comparative trial of telbivudine vs lamivudine in Chinese patients. Journal of Hepatology, 2007, 46 Suppl 1: S189.
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- 1. Perz JF, Armstrong GL, Farrington LA, et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol, 2006, 45(4): 529-538.
- 2. Chan HLY, Sung JJY. Hepatocellular carcinoma and hepatitis B virus. Semin. liver Dis, 2006, 26(2): 153-161.
- 3. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology, 2007, 45(2): 507-539.
- 4. Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions: version 5.0.1 Cochrane Collaboration, 2008.
- 5. Liaw YF, Gane E, Leung N, et al. 2-Year GLOBE trial results: telbivudine Is superior to lamivudine in patients with chronic hepatitis B. Gastroenterology, 2009, 136(2): 486-495.
- 6. Lai CL, Gane E, Liaw YF, et al. Telbivudine versus lamivudine in patients with chronic hepatitis B. N Engl J Med, 2007, 357(25): 2576-2588.
- 7. Hou J, Yin YK, Xu D, et al. Telbivudine versus lamivudine in Chinese patients with chronic hepatitis B: Results at 1 year of a randomized, double-blind trial. Hepatology, 2008, 47(2): 447-454.
- 8. Jia JD, Hou JL, Yin YK, et al. Two-year results of a phase III comparative trial of telbivudine vs lamivudine in Chinese patients. Journal of Hepatology, 2007, 46 Suppl 1: S189.
