同等的功效与单药恩替卡韦和替诺福韦，恩替卡韦联合治疗

StephenW

BMJ Open Gastroenterol. 2015 Jun 8;2(1):e000030. doi: 10.1136/bmjgast-2015-000030. eCollection 2015.
Comparable efficacy with entecavir monotherapy and tenofovir-entecavir combination in chronic hepatitis B patients.Baqai S1, Proudfoot J2, Xu R3, Kane S4, Clark M5, Gish R6.
Author information

• 1Department of Internal Medicine , Eden Medical Center , Castro Valley, California , USA.
• 2Biostatistics Unit , Clinical and Translational Research Institute, University of California, San Diego , San Diego, California , USA.
• 3Department of Mathematics , University of California, San Diego , San Diego, California , USA ; Department of Family and Preventive Medicine , University of California, San Diego , San Diego, California , USA.
• 4Interventional Endoscopy Services , California Pacific Medical Center , San Francisco, California , USA.
• 5Ibrahim El-Hefni Liver Biorepository, Department of Transplantation , California Pacific Medical Center , San Francisco, California , USA.
• 6Liver Transplant Program , Stanford University Medical Center , Stanford, California , USA ; Hepatitis B Foundation , Doylestown, Pennsylvania , USA ; St. Joseph's Hospital and Medical Center, Phoenix, Arizona , USA ; University of Nevada , Las Vegas, Nevada , USA ; Robert G. Gish Consultants, LLC, San Diego, California, USA.
  

AbstractOBJECTIVES: The long-term goal for chronic hepatitis B patients is to maintain viral suppression in order to reduce disease progression risk. Because patients with previous treatment failure may have multiple viral resistance mutations, finding effective therapy is challenging. Because recent studies have shown that the combination of entecavir and tenofovir is effective in achieving virological response in many patients with prior treatment failure and multiple drug resistance mutations, we compared outcomes with this combination versus monotherapy.
METHODS: With a retrospective chart review we compared results in 35 patients with previous treatment failure treated with the entecavir-tenofovir combination to results in patients treated with entecavir monotherapy.
RESULTS: Although combination therapy resulted in significantly faster achievement of DNA negativity compared to entecavir monotherapy, the modest ten-week advantage is unlikely to be important for most patients since entecavir resistance develops extremely slowly. Significantly more patients on combination therapy experienced viral breakthroughs, most of which were attributed to non-adherence due to difficulties with the combination regimen.
CONCLUSIONS: Our findings of reasonably comparable efficacy over time in the combination and monotherapy arms combined with the increased costs and compliance issues related to combination therapy weigh in favor of entecavir monotherapy in patients with previous treatment failure. However, because our study was a retrospective analysis of a small patient population, it will be important to confirm these findings with a randomised, controlled trial that compares these treatment approaches in treatment-experienced patients.


KEYWORDS: ADVERSE DRUG REACTIONS; ANTIVIRAL THERAPY; HEPATITIS B

StephenW

BMJ打开Gastroenterol。 2015年06月08日; 2（1）：e000030。 DOI：10.1136 / bmjgast-2015-000030。 eCollection 2015年。
同等的功效与单药恩替卡韦和替诺福韦，恩替卡韦联合治疗慢性乙型肝炎患者。
Baqai S1，Proudfoot J2，徐R3，凯恩S4，克拉克M5，基希R6。
作者信息

    教研室内科，伊甸园医学中心，卡斯特罗谷，加利福尼亚，美国。
    2Biostatistics单位，临床和转化研究所，美国加州大学圣地亚哥分校，圣地亚哥，美国加利福尼亚州。
    数学3Department，加州大学圣地亚哥分校，圣地亚哥分校，加州大学，美国;家庭部门与预防医学，加州大学圣地亚哥分校，圣地亚哥分校，加州大学，美国。
    4Interventional内窥镜检查服务，加州太平洋医疗中心，旧金山，美国加利福尼亚州。
    5Ibrahim埃尔 - Hefni肝Biorepository，移植，加州太平洋医疗中心，旧金山，加利福尼亚州，美国系。
    6Liver移植计划，斯坦福大学医学中心，斯坦福大学，加利福尼亚州，美国;乙型肝炎基金会，宾夕法尼亚州Doylestown，美国;圣若瑟医院和医疗中心，凤凰城，亚利桑那州，美国;内华达州，拉斯维加斯，内华达州，美国的大学;罗伯特·吉什顾问有限责任公司，圣迭戈，加利福尼亚州，美国。

抽象的
目的：

长期目标慢性乙型肝炎患者是维持抑制病毒，以降低疾病进展风险。由于患者既往治疗失败可能有多个病毒的耐药性突变，寻找有效的疗法是具有挑战性的。因为最近的研究已经表明，恩替卡韦和替诺福韦的组合是有效地实现与现有治疗失败和多重耐药性突变在许多患者的病毒学应答，我们比较结果与此组合与单一。
方法：

通过回顾性分析，我们比较结果35例与恩替卡韦，替诺福韦组合，恩替卡韦单药治疗的患者治疗结果以前的治疗失败。
结果：

虽然联合治疗导致显著更快实现脱氧核糖核酸消极相比恩替卡韦单一疗法中，适度的十周优点是不太可能是对大多数病人重要的，因为恩替卡韦耐药发展极为缓慢。显著更多患者联合治疗经历病毒突破，其中大部分是由于不遵守由于与组合方案的困难。
结论：

我们有理由同等的功效随着时间的推移，在组合和单药治疗武器结合相关的联合治疗增加的成本和法规遵从问题的调查结果权衡赞成恩替卡韦单药治疗的患者既往治疗失败。但是，由于我们的研究是一个小患者人群的回顾性分析，这将是重要的，以确认这些发现与一个随机对照试验，比较了这些治疗方法在治疗经验的患者。
关键词：

药物不良反应;抗病毒治疗;乙型肝炎

9病成医

楼主能不能用中文归纳一下文章的结论，这软件翻过来的中文还是中文吗。

lwkais

同意楼上意见，楼主就好人做到底吧

MP4

lwkais 发表于 2015-10-19 22:08
同意楼上意见，楼主就好人做到底吧

不能要求太高，楼主也不太懂中文