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

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 (R), Embase (R), 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.