Entecavir and interferon-α sequential therapy in Japanese patients with hepati

StephenW

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.

StephenW

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。

rocgao

是不是宣布恩替+干扰贯续治疗失败？

StephenW

回复 rocgao 的帖子

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

咬牙硬挺

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