Comparative analysis of the efficacies of entecavir capsules and lamivudine in chronic hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy profile of entecavir capsule (ETV) as a chronic hepatitis B therapy, as compared to lamivudine (LAM).</p><p><b>METHODS</b>In this multicenter, randomized, double-blind, parallel group evaluation of ETV, 232 subjects were administered a 96-week course of 0.5 mg/day ETV or 100 mg/day LAM. PCR measurement of hepatitis B virus (HBV) was conducted throughout the treatment course to determine achievement of complete virologic response (CVR; defined as less than 500 copies/ml of HBV DNA) or experience of virology rebound ( more than 500 copies/ml of HBV DNA after achievement of CVR).</p><p><b>RESULTS</b>After week-48 of treatment, the ETV group showed a higher CVR rate (90.3% vs. LAM: 59.4%) and lower virology rebound rate (1.9% vs. LAM: 13.9%). After week-96 of treatment, the ETV group continued to have a higher CVR rate (86.0% vs. LAM: 71.4%), and virology rebound was experienced by significantly less subjects in the ETV group (1.2% vs. LAM: 11.9%, P = 0.005).</p><p><b>CONCLUSION</b>ETV therapy can quickly and continuously suppress HBV replication in chronic hepatitis B patients, and has a lower resistance rate than LAM. Compared to LAM, ETV may be a superior long-term treatment choice for chronic hepatitis B.</p>

An economic evaluation of different treatments for HBeAg-positive chronic hepatitis B in China / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To assess the economic evaluation of short- and long-term antiviral treatments of HBeAg-positive chronic hepatitis B from the perspective of the Chinese health care system.</p><p><b>METHODS</b>A 10-health state Markov model was developed to estimate long-term cost and effectiveness of different treatments of HBeAg-positive CHB. Incremental cost-effectiveness analysis was then carried out.</p><p><b>RESULTS</b>In comparison with no antiviral treatment, lamivudine administered for 1-year was a highly cost-effective short-course treatment for HBeAg-positive CHB. However, of the treatments evaluated, lamivudine plus adefovir as a rescue medication or adefovir plus lamivudine as a rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. In comparison with 1 year lamivudine treatment, the incremental cost per Quality Adjusted Life Year (QALY) for treatment with lamivudine plus adefovir or adefovir plus lamivudine as a rescue medication for 5 years was CNY 25 115 and 35 577 respectively, which was 55.2% and 36.5% lower than the estimated international threshold value for China.</p><p><b>CONCLUSION</b>In comparison with no antiviral treatment, lamivudine administered for 1-year is a highly cost-effective short-course treatment. Longer duration antiviral treatments, lamivudine plus adefovir or adefovir plus lamivudine as a rescue medication are both cost-effective strategies, resulting in a more sustained decrease in the rate of disease progression.</p>