Comparison of renal safety of Telbivudine and Entecavir in Chronic Hepatitis B patients with renal impairment: A meta-analysis

Abstract Background:This study aimed to evaluate the renal safety of telbivudine(LdT) and entecavir(ETV) in chronic hepatitis B (CHB) patients with renal impairment.Methods:Studies published from January 1, 2010 to February 1, 2020 were identified using the PubMed, Web of Science, Scopus,Cochrane Library,ClinicalTrials.gov and CNKI (China National Knowledge Infrastructure).Finally,a total of 7 studies (1088 patients) with eGFR outcomes were retrieved and analyzed.The meta-analysis was conducted using RevMan 5.3.Results:The results of the 7 eligible studies analyzed suggested that the eGFR was both improved after LdT and ETV treatment.Compared with the baseline level,the eGFR was significantly improved with LdT (7.02 mL/min/1.73 m2 ) while slightly improved with ETV (1.72 mL/min/1.73 m2 ) after 1 years of treatment. The eGFR was significantly higher in the LdT therapy group than in the ETV group after 6 months(RR = 4.63, 95%CI: 0.73–8.54,Z = 2.33; P = 0.02)，1 year(RR = 3.35, 95%CI: 1.18–5.52,Z = 3.02; P = 0.002)，and 2 years(RR = 11.00, 95%CI: 4.84–17.15,Z = 3.50; P = 0.0005) of treatment . Conclusion: Our meta-analysis of current evidence demonstrated that in CHB patients with impaired renal function, LdT could be the better choice than ETV.