Tenofovir-Based Regimens Versus Entecavir for Chemoprevention and Survival in Chronic Hepatitis B: A Multicenter Propensity-Matched Analysis

Presenter: Alkasabrah O.

This retrospective cohort study evaluated long-term hepatic and survival outcomes associated with entecavir (ENT), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) in patients with chronic hepatitis B virus (HBV) infection. Adults with chronic hepatitis B virus (HBV) were identified and categorized according to antiviral exposure. Outcomes assessed included incident hepatocellular carcinoma (HCC), liver transplantation, incident cirrhosis, and all-cause mortality.

Following matching, 11,966 patients each were included in the ENT and TDF cohorts. The incidence of HCC was comparable between ENT and TDF (4.4% vs 4.0%; OR 1.08, 95% CI 0.95–1.24; p=0.24). However, TDF was associated with significantly lower all-cause mortality compared with ENT (12.7% vs 14.2%; OR 0.88, 95% CI 0.82–0.95; p<0.001), while liver transplantation was more frequent in the ENT cohort (14.0% vs 9.0%; OR 1.61, 95% CI 1.25–2.06; p<0.001). Rates of incident cirrhosis were similar between the two groups.

In a separate matched analysis including 9,069 patients treated with TAF and ENT, ENT was associated with significantly higher risks of HCC (4.0% vs 1.9%; OR 2.10, 95% CI 1.7–2.5; p<0.001), all-cause mortality (10.8% vs 8.1%; OR 1.38, 95% CI 1.3–1.5; p<0.001), liver transplantation (10.0% vs 3.0%; OR 3.52, 95% CI 2.3–5.3; p<0.001), and incident cirrhosis (8.9% vs 5.2%; OR 1.8, 95% CI 1.6–2.0; p<0.001) compared with TAF.

Overall, while ENT and TDF demonstrated comparable HCC risk reduction, tenofovir-based therapies—particularly TAF—were associated with more favorable long-term hepatic and survival outcomes.

Propensity-Matched Real-World Comparative Risk of Biliary and Pancreatic Events with Tirzepatide, Semaglutide, and Non-GLP-1 Therapies in Obesity and Diabetes

Presenter: Ghusn W.

This large real-world study evaluated the biliary and pancreatic safety profiles of GLP-1 receptor agonists (GLP-1RAs), including semaglutide and tirzepatide, in adults with obesity and type 2 diabetes. Adults aged ≥18 years with Body Mass Index (BMI) ≥30 kg/m² and type 2 diabetes initiating GLP-1RA therapy or DPP-4 inhibitors were included, while patients with baseline biliary or pancreatic disease were excluded. Primary and secondary outcomes included incident cholelithiasis, cholecystitis, cholangitis, acute pancreatitis, and cholecystectomy over 12 months.

After matching, 281,283 patients per group were included in the GLP-1RA versus Dipeptidyl peptidase-4 (DPP-4) inhibitor analysis, while 242,876 patients per group were included in the tirzepatide versus semaglutide comparison. Compared with DPP-4 inhibitors, GLP-1RA therapy was associated with significantly lower 1-year risks of cholelithiasis (HR 0.92, 95% CI 0.87–0.96), cholecystitis (HR 0.88, 95% CI 0.79–0.98), cholecystectomy (HR 0.51, 95% CI 0.38–0.69), cholangitis (HR 0.46, 95% CI 0.36–0.58), and pancreatitis (HR 0.68, 95% CI 0.61–0.76).

Within the GLP-1RA class, semaglutide was associated with modestly increased risks of cholelithiasis (HR 1.11, 95% CI 1.05–1.18) and cholecystitis (HR 1.22, 95% CI 1.10–1.37) compared with tirzepatide. No significant differences were observed between the two agents for pancreatitis, cholangitis, or cholecystectomy.

Overall, GLP-1RA therapy demonstrated a favourable biliary and pancreatic safety profile compared with DPP-4 inhibitors. Among GLP-1RAs, tirzepatide showed a comparatively safer profile than semaglutide, particularly with respect to gallbladder-related events.

DDW 2026, May 2-5, Chicago, IL