External validation of the modified PAGE-B score in Asian chronic hepatitis B patients receiving antiviral therapy

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Abstract

Background and Aims: The modified PAGE-B (mPAGE-B) score comprising age, gender, platelet count and albumin was recently proposed to predict hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients undergoing antivirals. Here, in the independent cohort, we externally validated the predictive performance of the mPAGE-B score and compared it with those of conventional HCC prediction models. Methods: We consecutively recruited CHB patients treated with lamivudine, entecavir or tenofovir as the first-line antiviral regimen. Patients with decompensated cirrhosis or HCC at baseline were excluded. Predictive performances of the mPAGE-B score and other models were assessed with comparison. Results: Among 1330 patients, 9.6% developed HCC during follow-up. The mPAGE-B score provided the highest Harrell's c-index (0.769), followed by the GAG-HCC (0.751), PAGE (0.744), REACH-B (0.686) and CU-HCC (0.618) scores. The mPAGE-B score showed the similar performance to the PAGE-B and GAG-HCC scores and the better performance than the REACH-B and CU-HCC scores. Cumulative HCC probabilities at 5- and 7-years were 0.0% and 0.0% in low-risk group (mPAGE-B score ≤ 8), 6.1% and 10.8% in intermediate-risk group (mPAGE-B score 9-12) and 18.7% and 26.7% in high-risk group (mPAGE-B score ≥ 13) respectively (both P < 0.001 between adjacent two groups). C-indices of the mPAGE-B score were 0.785 and 0.724 among subgroups treated with entecavir or tenofovir (n = 1011) and with lamivudine (n = 319), respectively, which are overall similar to those of the PAGE-B score. Conclusion: The mPAGE-B score showed acceptable predictive performances. Compared to the PAGE-B score, addition of albumin as a constituent provided the marginal benefit.

Original languageEnglish
JournalLiver International
DOIs
Publication statusPublished - 2019 Jan 1

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Chronic Hepatitis B
Antiviral Agents
Hepatocellular Carcinoma
Tenofovir
Lamivudine
Therapeutics
Albumins
Platelet Count
Fibrosis

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

@article{72c91cecb0bf44c3a16fe8422d74c79f,
title = "External validation of the modified PAGE-B score in Asian chronic hepatitis B patients receiving antiviral therapy",
abstract = "Background and Aims: The modified PAGE-B (mPAGE-B) score comprising age, gender, platelet count and albumin was recently proposed to predict hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients undergoing antivirals. Here, in the independent cohort, we externally validated the predictive performance of the mPAGE-B score and compared it with those of conventional HCC prediction models. Methods: We consecutively recruited CHB patients treated with lamivudine, entecavir or tenofovir as the first-line antiviral regimen. Patients with decompensated cirrhosis or HCC at baseline were excluded. Predictive performances of the mPAGE-B score and other models were assessed with comparison. Results: Among 1330 patients, 9.6{\%} developed HCC during follow-up. The mPAGE-B score provided the highest Harrell's c-index (0.769), followed by the GAG-HCC (0.751), PAGE (0.744), REACH-B (0.686) and CU-HCC (0.618) scores. The mPAGE-B score showed the similar performance to the PAGE-B and GAG-HCC scores and the better performance than the REACH-B and CU-HCC scores. Cumulative HCC probabilities at 5- and 7-years were 0.0{\%} and 0.0{\%} in low-risk group (mPAGE-B score ≤ 8), 6.1{\%} and 10.8{\%} in intermediate-risk group (mPAGE-B score 9-12) and 18.7{\%} and 26.7{\%} in high-risk group (mPAGE-B score ≥ 13) respectively (both P < 0.001 between adjacent two groups). C-indices of the mPAGE-B score were 0.785 and 0.724 among subgroups treated with entecavir or tenofovir (n = 1011) and with lamivudine (n = 319), respectively, which are overall similar to those of the PAGE-B score. Conclusion: The mPAGE-B score showed acceptable predictive performances. Compared to the PAGE-B score, addition of albumin as a constituent provided the marginal benefit.",
author = "Lee, {Hye Won} and Seungup Kim and Junyong Park and doyoung kim and SangHoon Ahn and KwangHyub Han and Kim, {Beom Kyung}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/liv.14129",
language = "English",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - External validation of the modified PAGE-B score in Asian chronic hepatitis B patients receiving antiviral therapy

AU - Lee, Hye Won

AU - Kim, Seungup

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Han, KwangHyub

AU - Kim, Beom Kyung

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Aims: The modified PAGE-B (mPAGE-B) score comprising age, gender, platelet count and albumin was recently proposed to predict hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients undergoing antivirals. Here, in the independent cohort, we externally validated the predictive performance of the mPAGE-B score and compared it with those of conventional HCC prediction models. Methods: We consecutively recruited CHB patients treated with lamivudine, entecavir or tenofovir as the first-line antiviral regimen. Patients with decompensated cirrhosis or HCC at baseline were excluded. Predictive performances of the mPAGE-B score and other models were assessed with comparison. Results: Among 1330 patients, 9.6% developed HCC during follow-up. The mPAGE-B score provided the highest Harrell's c-index (0.769), followed by the GAG-HCC (0.751), PAGE (0.744), REACH-B (0.686) and CU-HCC (0.618) scores. The mPAGE-B score showed the similar performance to the PAGE-B and GAG-HCC scores and the better performance than the REACH-B and CU-HCC scores. Cumulative HCC probabilities at 5- and 7-years were 0.0% and 0.0% in low-risk group (mPAGE-B score ≤ 8), 6.1% and 10.8% in intermediate-risk group (mPAGE-B score 9-12) and 18.7% and 26.7% in high-risk group (mPAGE-B score ≥ 13) respectively (both P < 0.001 between adjacent two groups). C-indices of the mPAGE-B score were 0.785 and 0.724 among subgroups treated with entecavir or tenofovir (n = 1011) and with lamivudine (n = 319), respectively, which are overall similar to those of the PAGE-B score. Conclusion: The mPAGE-B score showed acceptable predictive performances. Compared to the PAGE-B score, addition of albumin as a constituent provided the marginal benefit.

AB - Background and Aims: The modified PAGE-B (mPAGE-B) score comprising age, gender, platelet count and albumin was recently proposed to predict hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients undergoing antivirals. Here, in the independent cohort, we externally validated the predictive performance of the mPAGE-B score and compared it with those of conventional HCC prediction models. Methods: We consecutively recruited CHB patients treated with lamivudine, entecavir or tenofovir as the first-line antiviral regimen. Patients with decompensated cirrhosis or HCC at baseline were excluded. Predictive performances of the mPAGE-B score and other models were assessed with comparison. Results: Among 1330 patients, 9.6% developed HCC during follow-up. The mPAGE-B score provided the highest Harrell's c-index (0.769), followed by the GAG-HCC (0.751), PAGE (0.744), REACH-B (0.686) and CU-HCC (0.618) scores. The mPAGE-B score showed the similar performance to the PAGE-B and GAG-HCC scores and the better performance than the REACH-B and CU-HCC scores. Cumulative HCC probabilities at 5- and 7-years were 0.0% and 0.0% in low-risk group (mPAGE-B score ≤ 8), 6.1% and 10.8% in intermediate-risk group (mPAGE-B score 9-12) and 18.7% and 26.7% in high-risk group (mPAGE-B score ≥ 13) respectively (both P < 0.001 between adjacent two groups). C-indices of the mPAGE-B score were 0.785 and 0.724 among subgroups treated with entecavir or tenofovir (n = 1011) and with lamivudine (n = 319), respectively, which are overall similar to those of the PAGE-B score. Conclusion: The mPAGE-B score showed acceptable predictive performances. Compared to the PAGE-B score, addition of albumin as a constituent provided the marginal benefit.

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U2 - 10.1111/liv.14129

DO - 10.1111/liv.14129

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