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肝胆相照论坛 论坛 学术讨论& HBV English Entecavir and interferon-α sequential therapy in Ja ...
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Entecavir and interferon-α sequential therapy in Japanese patients with hepati [复制链接]

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发表于 2012-8-15 09:29 |只看该作者 |倒序浏览 |打印
http://www.springerlink.com/content/38762457x0341165/?MUD=MP
Entecavir and interferon-α sequential therapy in Japanese patients with hepatitis B e antigen-positive chronic hepatitis B

Masaru Enomoto, Shuhei Nishiguchi, Akihiro Tamori, Sawako Kobayashi and Hiroki Sakaguchi, et al.

Journal of Gastroenterology, Online First™, 1 August 2012

   
Abstract
Background  
The outcomes of sequential therapy with lamivudine followed by interferon have been unsatisfactory in Japanese patients with hepatitis B envelope antigen (HBeAg)-positive chronic hepatitis B. However, the efficacy of sequential therapy with entecavir and interferon remains unclear.
Methods  
Twenty-four HBeAg-positive patients (23 men and 1 woman; mean age 39 ± 7 years) received entecavir 0.5 mg alone for 36–52 weeks, followed by entecavir plus interferon-α for 4 weeks, and lastly by interferon-α alone for 20 weeks. Twenty-three patients had genotype C infection, and one had genotype A infection.
Results  
No entecavir-resistant mutant variants emerged in any patient. Hepatitis flare occurred in three patients during interferon-α treatment after the withdrawal of entecavir, but none had hepatic decompensation. Serum hepatitis B surface antigen levels did not change during or after therapy. Serum hepatitis B core-related antigen levels were significantly decreased at the start (P < 0.0001) and at the end of interferon-α treatment (P < 0.0001), but returned to baseline levels after treatment. Twenty-four weeks after the completion of the sequential therapy, a sustained biochemical, virological, and serological response was achieved in 5 (21 %) patients. The proportion of patients in whom HBeAg was lost during entecavir treatment was significantly higher among those with a sustained response than among those with no response (P = 0.015).
Conclusions  
The rate of response to sequential therapy with entecavir and interferon-α in Japanese patients with HBeAg-positive chronic hepatitis B was not higher than the rate in previous studies of lamivudine followed by interferon.

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发表于 2012-8-15 09:29 |只看该作者
本帖最后由 StephenW 于 2012-8-15 09:30 编辑

恩替卡韦和α-干扰素序贯疗法在日本患者与B型肝炎e抗原阳性的慢性乙型肝炎

榎本胜,西口修平,田森田昭宏,小林和子和坂口弘树,等。

胃肠病学杂志,2012年8月1日,网上第一™

背景
乙肝信封抗原(HBeAg)阳性的慢性乙型肝炎然而,已经在日本患者干扰素与拉米夫定序贯治疗的结果不满意,与恩替卡韦和干扰素序贯疗法的疗效仍不清楚。
方法
二十四HBeAg阳性患者(23名男子和1名妇女,平均年龄39±7岁)接受恩替卡韦0.5毫克单独为36-52周,4周恩替卡韦加α-干扰素,最后由α-干扰素单独20周。 23例C基因型感染,和一个基因型A群流行性脑膜炎感染。
结果
没有恩替卡韦耐药突变的变种出现在任何病人。 α-干扰素治​​疗肝炎耀斑发生在三个病人在恩替卡韦后撤出,但没有肝功能失代偿。血清乙型肝炎表面抗原水平没有改变治疗期间或之后。开始时(P <0.001)和α-干扰素治​​疗(P <0.0001)结束血清乙型肝炎核心相关抗原水平显着下降,但治疗后返回到基线水平。序贯疗法完成二十四个星期后,取得了持续的生化,病毒学和血清学反应5例(21%)。之间的持续反应在其中HBeAg的恩替卡韦治疗过程中丢失的患者的比例显着高于那些没有反应(P = 0.015)中。
结论
与恩替卡韦和α-干扰素序贯疗法在日本与HBeAg阳性慢性乙型肝炎患者的反应率不高于率在以前的干扰素,拉米夫定研究。
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发表于 2012-8-15 14:12 |只看该作者
是不是宣布恩替+干扰贯续治疗失败?

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发表于 2012-8-15 16:33 |只看该作者
本帖最后由 StephenW 于 2012-8-15 16:34 编辑

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HBeAg阳性 -"单独恩替卡韦0.5毫克单独36-52周,恩替卡韦加α-干扰素4周,最后α-干扰素单独20周。"
这序贯治疗不是一个成功的

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发表于 2012-8-15 21:36 |只看该作者
在有全新治疗药物出现之前,依靠不断改进现有药物的使用策略很难取得更为显著的疗效,1 1<2
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