Peginterferon Alfa-2b May Be Effective When Standard HBV Therapy Fails 常规HBV治疗无效时聚乙二醇干扰素α-2b可能有效
NEW YORK (Reuters Health) Dec 27 - Approximately one-third of patients with HBeAg-positive chronic hepatitis B who failed previous treatment with standard interferon (IFN) or lamivudine will respond to peginterferon alfa-2b (Peg-IFN alfa2b), research suggests. 纽约(路透社健康栏目)12月27日消息,研究表明,约有三分之一的乙型肝炎e抗原阳性的慢性乙肝患者在使用常规的干扰素或拉米夫定治疗无效后,聚乙二醇干扰素α-2b有效。 High serum alanine aminotransferase (ALT) levels at the start of Peg-IFN alfa2b therapy is the best predictor of response in these patients, note researchers in the November American Journal of Gastroenterology. 美国胃肠病学杂志11月刊报道,聚乙二醇干扰素α-2b治疗前血清高丙氨酸氨基转移酶(ALT)水平患者疗效较好。 Dr. Hajo J. Flink from Erasmus Medical Center, Rotterdam, The Netherlands, and an international team investigated the efficacy -- defined as loss of HBeAg at the end of follow up -- of Peg-IFN alfa2b in 76 previous non-responders to standard IFN or lamivudine. Thirty-seven had failed IFN, 17 had failed lamivudine, and 22 had failed both therapies. 荷兰鹿特丹Erasmus医疗中心的Hajo J. Flink博士及其国际的团队研究了76例接受聚乙二醇干扰素α-2b治疗,随访结束时乙型肝炎e抗原转阴。这76例患者对常规干扰素或拉米夫定治疗无效,其中37例干扰素无效,17例拉米夫定无效,22例两者都无效。 All subjects received 52 weeks of Peg-IFN alfa2b (100 micrograms once weekly) combined with either 100 milligrams lamivudine daily or placebo. Subjects were followed for 26 weeks after the end of treatment. 所有受试者接受聚乙二醇干扰素α-2b治疗每周一次100微克,连用52周,同时联合用每日100毫克拉米夫定或安慰剂。治疗结束后随访26周。 Thirteen nonresponders to previous IFN (35%), 5 nonresponders to previous lamivudine therapy (29%), and 4 nonresponders to both drugs (22%) responded to treatment with Peg-IFN alfa2b, Dr. Flink and colleagues report. Flink博士及其同事说,先前对常规干扰素无效的13例患者(占35%),对拉米夫定无效的5例患者(占29%),对两者均无效的4例患者(占22%)对聚乙二醇干扰素α-2b治疗有效。 The combination of Peg-IFN alfa2b and lamivudine did not lead to higher response rates relative to Peg-IFN alfa2b alone for any of the previous nonresponder groups, they note. 他们说,对先前任何组治疗无效的患者,聚乙二醇干扰素α-2b联合拉米夫定治疗并没有比单独聚乙二醇干扰素α-2b有效率增高。 The best predictor of response to Peg-IFN alfa2b in previous nonresponders was a baseline ALT of greater than 4 times the upper limit of normal. Fifty-three percent of patients with this ALT level responded to Peg-IFN alfa2b compared with 20% of those with lower ALT levels at the start of treatment. 常规治疗无效,ALT高于正常值上限的4倍的患者,聚乙二醇干扰素α-2b的疗效较好。这个水平的ALT患者53%疗效较好,而治疗时低水平的ALT患者20%有效。 Am J Gastroenterol 2006;101:2523-2529. 美国胃肠病学杂志2006;101:2523-2529 |