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Personalized Antiviral Drug Selection in Patients With Chronic Hepatitis B Using a Machine Learning Model: A Multinational Study
- Title
- Personalized Antiviral Drug Selection in Patients With Chronic Hepatitis B Using a Machine Learning Model: A Multinational Study
- Authors
- Hur; Moon Haeng; Park; Min Kyung; Yip; Terry Cheuk-Fung; Chen; Chien-Hung; Lee; Hyung-Chul; Choi; Won-Mook; Kim; Seung Up; Lim; Young-Suk; Soo Young; Wong; Grace Lai-Hung; Sinn; Dong Hyun; Jin; Young-Joo; Sung Eun; Peng; Cheng-Yuan; Shin; Hyun Phil; Chi-Yi; Hwi Young; Han Ah; Seo; Yeon Seok; Jun; Dae Won; Yoon; Eileen L.; Sohn; Joo Hyun; Ahn; Sang Bong; Shim; Jae-Jun; Jeong; Soung Won; Cho; Yong Kyun; Hyoung Su; Jang; Myoung-Jin; Yoon Jun; Jung-Hwan; Jeong-Hoon
- Ewha Authors
- 김휘영
- SCOPUS Author ID
- 김휘영
- Issue Date
- 2023
- Journal Title
- The American journal of gastroenterology
- ISSN
- 1572-0241
- Citation
- The American journal of gastroenterology vol. 118, no. 11, pp. 1963 - 1972
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- INTRODUCTION: Tenofovir disoproxil fumarate (TDF) is reportedly superior or at least comparable to entecavir (ETV) for the prevention of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B; however, it has distinct long-term renal and bone toxicities. This study aimed to develop and validate a machine learning model (designated as Prediction of Liver cancer using Artificial intelligence-driven model for Network-antiviral Selection for hepatitis B [PLAN-S]) to predict an individualized risk of HCC during ETV or TDF therapy. METHODS: This multinational study included 13,970 patients with chronic hepatitis B. The derivation (n = 6,790), Korean validation (n = 4,543), and Hong Kong-Taiwan validation cohorts (n = 2,637) were established. Patients were classified as the TDF-superior group when a PLAN-S-predicted HCC risk under ETV treatment is greater than under TDF treatment, and the others were defined as the TDF-nonsuperior group. RESULTS: The PLAN-S model was derived using 8 variables and generated a c-index between 0.67 and 0.78 for each cohort. The TDF-superior group included a higher proportion of male patients and patients with cirrhosis than the TDF-nonsuperior group. In the derivation, Korean validation, and Hong Kong-Taiwan validation cohorts, 65.3%, 63.5%, and 76.4% of patients were classified as the TDF-superior group, respectively. In the TDF-superior group of each cohort, TDF was associated with a significantly lower risk of HCC than ETV (hazard ratio = 0.60-0.73, all P < 0.05). In the TDF-nonsuperior group, however, there was no significant difference between the 2 drugs (hazard ratio = 1.16-1.29, all P > 0.1). DISCUSSION: Considering the individual HCC risk predicted by PLAN-S and the potential TDF-related toxicities, TDF and ETV treatment may be recommended for the TDF-superior and TDF-nonsuperior groups, respectively. Copyright © 2023 by The American College of Gastroenterology.
- DOI
- 10.14309/ajg.0000000000002234
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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