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Adefovir144周治疗HBeAg+的疗效(2005.4.23) [复制链接]

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1
发表于 2005-4-22 23:56
Adefovir Week 144 Efficacy in HBeAg+

Reported by Jules Levin

"Increasing Serologic, Virologic and Biochemical Response Over Time to Adefovir (ADV) 10 mg in HBeAg+ Chronic Hepatitis (CHB) Patients"

P Marcellin1, TT Chang2, SG Lim3, W Sievert4, M Tong5, S Arterburn6, S Xiong6, CL Brosgart6, and G Currie6 for the 437 Study Group1Hopital Beaujon, Clichy, France; 2National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China; 3National University Hospital, Singapore; 4Monash Medical Centre, Victoria, Australia; 5Huntington Medical Center Research Institute, Huntington, California, USA;6Gilead Sciences, Inc., Foster City, California, USA

Marcellin reported this data and information at the EASL meeting, April 13-17, Paris, 2005.

Investigator summary:

The proportion of patients with clinical benefit increased over time:

--Undetectable HBV DNA increased (48% week 144)

--ALT normalization increased (80% week 144)

--HBeAg loss and seroconversion increased (53% & 46% week 144)

Safety profile over 144 weeks consistent with first 48 weeks:

--safety profile similar to placebo at 48 weeks

Resistance to adefovir is delayed and infrequent in this study population.

INTRODUCTION

Nucleotide analogue of adenosine monophosphate

Activity against wild-type and lamivudine-resistant (LAM-R) HBV1-5

10 mg once daily orally

Durable HBV DNA suppression with a high threshold for the development of resistance

Safety profile similar to placebo in 48 week controlled trials

KEY INCLUSION CRITERIA

HBeAg+ , anti-HBe- and HBsAg+

Compensated liver disease

HBV DNA ³ 106 copies/mL

ALT x ULN ³ 1.2 —10

Adequate renal function

STUDY DESIGN*

*misallocation: patients received significant periods of intermittent dosing in Yr 2.

HBV DNA UNDETECTABLE & ALT NORMALIZED

Kaplan-Meier Estimates

Reported by Jules Levin

"Increasing Serologic, Virologic and Biochemical Response Over Time to Adefovir (ADV) 10 mg in HBeAg+ Chronic Hepatitis (CHB) Patients"

P Marcellin1, TT Chang2, SG Lim3, W Sievert4, M Tong5, S Arterburn6, S Xiong6, CL Brosgart6, and G Currie6 for the 437 Study Group1Hopital Beaujon, Clichy, France; 2National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China; 3National University Hospital, Singapore; 4Monash Medical Centre, Victoria, Australia; 5Huntington Medical Center Research Institute, Huntington, California, USA;6Gilead Sciences, Inc., Foster City, California, USA

Marcellin reported this data and information at the EASL meeting, April 13-17, Paris, 2005.

Investigator summary:

The proportion of patients with clinical benefit increased over time:

--Undetectable HBV DNA increased (48% week 144)

--ALT normalization increased (80% week 144)

--HBeAg loss and seroconversion increased (53% & 46% week 144)

Safety profile over 144 weeks consistent with first 48 weeks:

--safety profile similar to placebo at 48 weeks

Resistance to adefovir is delayed and infrequent in this study population.

INTRODUCTION

Nucleotide analogue of adenosine monophosphate

Activity against wild-type and lamivudine-resistant (LAM-R) HBV1-5

10 mg once daily orally

Durable HBV DNA suppression with a high threshold for the development of resistance

Safety profile similar to placebo in 48 week controlled trials

KEY INCLUSION CRITERIA

HBeAg+ , anti-HBe- and HBsAg+

Compensated liver disease

HBV DNA ³ 106 copies/mL

ALT x ULN ³ 1.2 —10

Adequate renal function

STUDY DESIGN*

*misallocation: patients received significant periods of intermittent dosing in Yr 2.

HBV DNA UNDETECTABLE & ALT NORMALIZED

Kaplan-Meier Estimates

HBeAg LOSS & SEROCONVERSION OVER TIME

Kaplan-Meier Estimates

DURABILITY of HBeAg SEROCONVERSION OFF THERAPY

Median duration off ADV therapy: 55 weeks (range 5-114)

No patient who discontinued treatment with adefovir had a serum creatinine elevation >0.5 mg/dL above baseline or a serum phosphorous <2.0 mg/dL.

No patient had an ALT elevation accompanied by signs of worsening liver function.

RESISTANCE EVALUATION

All samples with detectable serum HBV DNA by PCR (>1000 copies/ml) at weeks 48 & 144* were analyzed.

--Incidence of ADV resistance at week 144* (3%, 2/65)

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