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Abstract：
Renal safety is an important factor in selecting the most appropriate nucleos(t)ide analog (NA) treatment for patients with chronic hepatitis B (CHB). This systematic literature review and network meta-analysis aimed to assess renal function associated with telbivudine treatment compared to other NAs in patients with CHB.
A systematic literature search via Medline, Medline In-Process, Embase, and the Cochrane library for publications of randomized controlled trials and observational studies was conducted. Network meta-analysis was performed to compare renal function with telbivudine treatment versus other NAs after 1 year of therapy.
Overall, 40 (six randomized controlled and 34 observational) studies were included for review. Telbivudine consistently showed an improvement in renal function as measured by an estimated glomerular filtration rate (eGFR) over various time points regardless of the method of measurement. Changes in eGFR (mL/min) from baseline and corresponding 95% credible intervals with various NAs were as follows: monotherapies (telbivudine: 7.78 [6.91, 8.65], entecavir: -1.07 [-4.80, 2.62], lamivudine: -6.08 [-13.35, 1.15], tenofovir: -9.53 [-14.31, -4.89]) and combination therapies (telbivudine + adefovir: 8.37 [-34.00, 50.34], telbivudine + tenofovir: 8.29 [-0.05, 16.64], entecavir + adefovir: 4.15 [-38.55, 46.37], telbivudine + lamivudine: 0.51 [-11.77, 12.96], and lamivudine + adefovir: -0.39 [-42.48, 41.21]). At 1 year, the change in eGFR from baseline was significantly higher with telbivudine compared to other NAs.
The systematic literature review and network meta-analysis provide evidence that telbivudine is associated with significant improvement in renal function in patients with CHB, either alone or in combination with other NAs.
Novartis Pharma AG.
A systematic literature search via Medline, Medline In-Process, Embase, and the Cochrane library for publications of randomized controlled trials and observational studies was conducted. Network meta-analysis was performed to compare renal function with telbivudine treatment versus other NAs after 1 year of therapy.
Overall, 40 (six randomized controlled and 34 observational) studies were included for review. Telbivudine consistently showed an improvement in renal function as measured by an estimated glomerular filtration rate (eGFR) over various time points regardless of the method of measurement. Changes in eGFR (mL/min) from baseline and corresponding 95% credible intervals with various NAs were as follows: monotherapies (telbivudine: 7.78 [6.91, 8.65], entecavir: -1.07 [-4.80, 2.62], lamivudine: -6.08 [-13.35, 1.15], tenofovir: -9.53 [-14.31, -4.89]) and combination therapies (telbivudine + adefovir: 8.37 [-34.00, 50.34], telbivudine + tenofovir: 8.29 [-0.05, 16.64], entecavir + adefovir: 4.15 [-38.55, 46.37], telbivudine + lamivudine: 0.51 [-11.77, 12.96], and lamivudine + adefovir: -0.39 [-42.48, 41.21]). At 1 year, the change in eGFR from baseline was significantly higher with telbivudine compared to other NAs.
The systematic literature review and network meta-analysis provide evidence that telbivudine is associated with significant improvement in renal function in patients with CHB, either alone or in combination with other NAs.
Novartis Pharma AG.
摘要：
肾脏安全性是为慢性乙型肝炎（CHB）患者选择最合适的核苷（t）ide类似物（NA）治疗的重要因素。本系统文献综述和网络荟萃分析旨在评估与替比夫定治疗相关的肾功能，与CHB患者的其他NAs相比。
通过Medline进行系统的文献检索，Medline正在进行中,Embase,和Cochrane图书馆进行了随机对照试验和观察性研究的出版物。进行网络荟萃分析以比较替比夫定治疗与其他NAs治疗1年后的肾功能。
总的来说，纳入40项(6项随机对照研究和34项观察性研究)进行综述。无论测量方法如何，通过估算的肾小球滤过率（eGFR）在各个时间点测得的替比夫定始终显示出肾功能的改善。eGFR（mL/min）从基线和相应的95％可信间隔与各种NA的变化如下：单一疗法（替比夫定：7.78[6.91，8.65]，恩替卡韦：-1.07[-4.80,2.62]，拉米夫定:-6.08[-13.35,1.15],替诺福韦：-9.53[-14.31，-4.89]）和联合治疗（替比夫定+阿德福韦：8.37[-34.00，50.34]，替比夫定+替诺福韦：8.29[-0.05，16.64]，恩替卡韦+阿德福韦：4.15[-38.55，46.37]，替比夫定+拉米夫定：0.51[-11.77,12.96]，和拉米夫定+阿德福韦：-0.39[-42.48，41.21]）。在1年,替比夫定的eGFR相对于基线的变化显著高于其他NAs.
系统文献综述和网络荟萃分析提供了证据，证明替比夫定与慢性乙型肝炎患者肾功能的显着改善有关，单独或与其他NAs组合。
诺华制药公司.
通过Medline进行系统的文献检索，Medline正在进行中,Embase,和Cochrane图书馆进行了随机对照试验和观察性研究的出版物。进行网络荟萃分析以比较替比夫定治疗与其他NAs治疗1年后的肾功能。
总的来说，纳入40项(6项随机对照研究和34项观察性研究)进行综述。无论测量方法如何，通过估算的肾小球滤过率（eGFR）在各个时间点测得的替比夫定始终显示出肾功能的改善。eGFR（mL/min）从基线和相应的95％可信间隔与各种NA的变化如下：单一疗法（替比夫定：7.78[6.91，8.65]，恩替卡韦：-1.07[-4.80,2.62]，拉米夫定:-6.08[-13.35,1.15],替诺福韦：-9.53[-14.31，-4.89]）和联合治疗（替比夫定+阿德福韦：8.37[-34.00，50.34]，替比夫定+替诺福韦：8.29[-0.05，16.64]，恩替卡韦+阿德福韦：4.15[-38.55，46.37]，替比夫定+拉米夫定：0.51[-11.77,12.96]，和拉米夫定+阿德福韦：-0.39[-42.48，41.21]）。在1年,替比夫定的eGFR相对于基线的变化显著高于其他NAs.
系统文献综述和网络荟萃分析提供了证据，证明替比夫定与慢性乙型肝炎患者肾功能的显着改善有关，单独或与其他NAs组合。
诺华制药公司.
