Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B

Hye Yeon Chon; Jae Seung Lee; Hye Won Lee; Ho Soo Chun; Beom Kyung Kim; Won Young Tak; Jun Yong Park; Young Oh Kweon; Do Young Kim; Sang Hoon Ahn; Se Young Jang; Soo Young Park; Seung Up Kim

doi:10.1016/j.cgh.2021.06.001

Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B

Hye Yeon Chon, Jae Seung Lee, Hye Won Lee, Ho Soo Chun, Beom Kyung Kim, Won Young Tak, Jun Yong Park, Young Oh Kweon, Do Young Kim, Sang Hoon Ahn, Se Young Jang, Soo Young Park, Seung Up Kim

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background & Aims: Cirrhosis and age (CAGE-B) and stiffness and age (SAGE-B) models assess the risk of hepatocellular carcinoma (HCC) development in white patients with chronic hepatitis B (CHB) undergoing sustained antiviral therapy (AVT). Herein, we checked the predictive performance of these models in Asian patients with CHB. Methods: We reviewed 734 treatment-naive patients with CHB who started entecavir between 2006 and 2011 and were followed up for more than 5 years without HCC development during AVT. The predictive performance of CAGE-B and SAGE-B models was calculated using area under the receiver operating characteristic curves (AUROCs). Results: Median liver stiffness assessed using transient elastography after 5 years of AVT was 6.8 kPa. Median CAGE-B and SAGE-B models after 5 years of AVT were 7.0 and 6.0, respectively. More than 5 years after AVT initiation, 66 patients (9.0%) developed HCC. The AUROCs of the CAGE-B and SAGE-B models were 0.764 and 0.785 after 7 years and 0.799 and 0.802 after 10 years of AVT, respectively. The cumulative incidence of HCC was significantly higher in the high-risk groups according to CAGE-B and SAGE-B risk stratification than in the medium- and low-risk groups (P < .05 in all cases). The SAGE-B model showed a higher likelihood ratio (χ²) (76.2 vs 71.4) and linear trend (χ²) (74.1 vs 58.6) than the CAGE-B model, whereas the CAGE-B model showed higher Akaike information criteria (64.3 vs 50.3). Conclusions: Both SAGE-B and CAGE-B showed acceptable performance in predicting HCC after 5 years of AVT in Asian patients with CHB.

Original language	English
Pages (from-to)	e794-e807
Journal	Clinical Gastroenterology and Hepatology
Volume	20
Issue number	4
DOIs	https://doi.org/10.1016/j.cgh.2021.06.001
Publication status	Published - 2022 Apr

Bibliographical note

Funding Information:
Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding Information:
Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, GSK, Bayer, and Eisai; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts.

Publisher Copyright:
© 2022 AGA Institute

All Science Journal Classification (ASJC) codes

Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.cgh.2021.06.001

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Chon, H. Y., Lee, J. S., Lee, H. W., Chun, H. S., Kim, B. K., Tak, W. Y., Park, J. Y., Kweon, Y. O., Kim, D. Y., Ahn, S. H., Jang, S. Y., Park, S. Y., & Kim, S. U. (2022). Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B. Clinical Gastroenterology and Hepatology, 20(4), e794-e807. https://doi.org/10.1016/j.cgh.2021.06.001

@article{657d3c33b94f4b8da1fc71195337e878,

title = "Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B",

abstract = "Background & Aims: Cirrhosis and age (CAGE-B) and stiffness and age (SAGE-B) models assess the risk of hepatocellular carcinoma (HCC) development in white patients with chronic hepatitis B (CHB) undergoing sustained antiviral therapy (AVT). Herein, we checked the predictive performance of these models in Asian patients with CHB. Methods: We reviewed 734 treatment-naive patients with CHB who started entecavir between 2006 and 2011 and were followed up for more than 5 years without HCC development during AVT. The predictive performance of CAGE-B and SAGE-B models was calculated using area under the receiver operating characteristic curves (AUROCs). Results: Median liver stiffness assessed using transient elastography after 5 years of AVT was 6.8 kPa. Median CAGE-B and SAGE-B models after 5 years of AVT were 7.0 and 6.0, respectively. More than 5 years after AVT initiation, 66 patients (9.0%) developed HCC. The AUROCs of the CAGE-B and SAGE-B models were 0.764 and 0.785 after 7 years and 0.799 and 0.802 after 10 years of AVT, respectively. The cumulative incidence of HCC was significantly higher in the high-risk groups according to CAGE-B and SAGE-B risk stratification than in the medium- and low-risk groups (P < .05 in all cases). The SAGE-B model showed a higher likelihood ratio (χ2) (76.2 vs 71.4) and linear trend (χ2) (74.1 vs 58.6) than the CAGE-B model, whereas the CAGE-B model showed higher Akaike information criteria (64.3 vs 50.3). Conclusions: Both SAGE-B and CAGE-B showed acceptable performance in predicting HCC after 5 years of AVT in Asian patients with CHB.",

author = "Chon, {Hye Yeon} and Lee, {Jae Seung} and Lee, {Hye Won} and Chun, {Ho Soo} and Kim, {Beom Kyung} and Tak, {Won Young} and Park, {Jun Yong} and Kweon, {Young Oh} and Kim, {Do Young} and Ahn, {Sang Hoon} and Jang, {Se Young} and Park, {Soo Young} and Kim, {Seung Up}",

note = "Funding Information: Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, GSK, Bayer, and Eisai; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts. Publisher Copyright: {\textcopyright} 2022 AGA Institute",

year = "2022",

month = apr,

doi = "10.1016/j.cgh.2021.06.001",

language = "English",

volume = "20",

pages = "e794--e807",

journal = "Clinical Gastroenterology and Hepatology",

issn = "1542-3565",

publisher = "W.B. Saunders Ltd",

number = "4",

}

Chon, HY, Lee, JS, Lee, HW, Chun, HS, Kim, BK, Tak, WY, Park, JY, Kweon, YO, Kim, DY, Ahn, SH, Jang, SY, Park, SY & Kim, SU 2022, 'Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B', Clinical Gastroenterology and Hepatology, vol. 20, no. 4, pp. e794-e807. https://doi.org/10.1016/j.cgh.2021.06.001

TY - JOUR

T1 - Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B

AU - Chon, Hye Yeon

AU - Lee, Jae Seung

AU - Lee, Hye Won

AU - Chun, Ho Soo

AU - Kim, Beom Kyung

AU - Tak, Won Young

AU - Park, Jun Yong

AU - Kweon, Young Oh

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Jang, Se Young

AU - Park, Soo Young

AU - Kim, Seung Up

N1 - Funding Information: Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Funding Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, GSK, Bayer, and Eisai; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts. Publisher Copyright: © 2022 AGA Institute

PY - 2022/4

Y1 - 2022/4

N2 - Background & Aims: Cirrhosis and age (CAGE-B) and stiffness and age (SAGE-B) models assess the risk of hepatocellular carcinoma (HCC) development in white patients with chronic hepatitis B (CHB) undergoing sustained antiviral therapy (AVT). Herein, we checked the predictive performance of these models in Asian patients with CHB. Methods: We reviewed 734 treatment-naive patients with CHB who started entecavir between 2006 and 2011 and were followed up for more than 5 years without HCC development during AVT. The predictive performance of CAGE-B and SAGE-B models was calculated using area under the receiver operating characteristic curves (AUROCs). Results: Median liver stiffness assessed using transient elastography after 5 years of AVT was 6.8 kPa. Median CAGE-B and SAGE-B models after 5 years of AVT were 7.0 and 6.0, respectively. More than 5 years after AVT initiation, 66 patients (9.0%) developed HCC. The AUROCs of the CAGE-B and SAGE-B models were 0.764 and 0.785 after 7 years and 0.799 and 0.802 after 10 years of AVT, respectively. The cumulative incidence of HCC was significantly higher in the high-risk groups according to CAGE-B and SAGE-B risk stratification than in the medium- and low-risk groups (P < .05 in all cases). The SAGE-B model showed a higher likelihood ratio (χ2) (76.2 vs 71.4) and linear trend (χ2) (74.1 vs 58.6) than the CAGE-B model, whereas the CAGE-B model showed higher Akaike information criteria (64.3 vs 50.3). Conclusions: Both SAGE-B and CAGE-B showed acceptable performance in predicting HCC after 5 years of AVT in Asian patients with CHB.

AB - Background & Aims: Cirrhosis and age (CAGE-B) and stiffness and age (SAGE-B) models assess the risk of hepatocellular carcinoma (HCC) development in white patients with chronic hepatitis B (CHB) undergoing sustained antiviral therapy (AVT). Herein, we checked the predictive performance of these models in Asian patients with CHB. Methods: We reviewed 734 treatment-naive patients with CHB who started entecavir between 2006 and 2011 and were followed up for more than 5 years without HCC development during AVT. The predictive performance of CAGE-B and SAGE-B models was calculated using area under the receiver operating characteristic curves (AUROCs). Results: Median liver stiffness assessed using transient elastography after 5 years of AVT was 6.8 kPa. Median CAGE-B and SAGE-B models after 5 years of AVT were 7.0 and 6.0, respectively. More than 5 years after AVT initiation, 66 patients (9.0%) developed HCC. The AUROCs of the CAGE-B and SAGE-B models were 0.764 and 0.785 after 7 years and 0.799 and 0.802 after 10 years of AVT, respectively. The cumulative incidence of HCC was significantly higher in the high-risk groups according to CAGE-B and SAGE-B risk stratification than in the medium- and low-risk groups (P < .05 in all cases). The SAGE-B model showed a higher likelihood ratio (χ2) (76.2 vs 71.4) and linear trend (χ2) (74.1 vs 58.6) than the CAGE-B model, whereas the CAGE-B model showed higher Akaike information criteria (64.3 vs 50.3). Conclusions: Both SAGE-B and CAGE-B showed acceptable performance in predicting HCC after 5 years of AVT in Asian patients with CHB.

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ER -

Predictive Performance of CAGE-B and SAGE-B Models in Asian Treatment-Naive Patients Who Started Entecavir for Chronic Hepatitis B

Abstract

Bibliographical note

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UN SDGs

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