Changes in serum alanine aminotransferase levels in telbivudine versus lamivudine treatment for chronic hepatitis B: A meta-analysis

• Published in: Journal of international medical research 2015-04, Vol.43 (2), p.161-172
• Main Authors: Dai, Min, Xiao, Ge-Min, Wang, Feng-Lin, Zhang, Jiong-Shan, Li, Yang-Mei, Yang, Hong-Zhi
• Format: Article
• Language: English
• Subjects: Alanine Transaminase - blood; Antiviral Agents - therapeutic use; Biomarkers - blood; Hepatitis B, Chronic - blood; Hepatitis B, Chronic - drug therapy; Humans; Lamivudine - therapeutic use; Thymidine - analogs & derivatives; Thymidine - therapeutic use; Treatment Outcome
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060514556664

Objective A meta-analysis to compare the efficacy and safety of telbivudine (TBV) and lamivudine (LAM) in patients with chronic hepatitis B (CHB), assessed via changes in serum alanine aminotransferase (ALT) levels. Method The electronic literature databases PubMed®, Embase®, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine and China National Knowledge Infrastructure were searched for relevant studies. The effect of TBV and LAM treatment on serum ALT was assessed using standard mean differences (SMDs) and 95% confidence intervals (CI). Results The meta-analysis included six studies (TBV n = 202; LAM, n = 208). Post-treatment ALT levels were significantly lower than pretreatment values for both TBV and LAM (TBV: SMD = 3.00, 95%CI 1.91, 4.09; LAM: SMD = 2.33, 95%CI 1.58, 3.07). Post-treatment ALT was significantly lower after treatment with TBV than LAM (SMD = 0.58, 95%CI 0.21, 0.94). Conclusion Both LAM and TBV are effective in normalizing ALT levels in patients with CHB, but TBV may be a better choice due to its lower rates of drug resistance.