基于恩替卡韦的挽救疗法在拉米夫定耐药慢性乙型肝炎患者

StephenW

Pharmazie. 2018 Apr 2;73(4):223-247. doi: 10.1691/ph.2018.7982.
Efficacy of entecavir-based rescue therapy in lamivudine-resistant chronic hepatitis B patients in China: a retrospective study.
Li W, Wang L, Liu Y, Li Y, Yu S.
Abstract

Limited studies have investigated the antiviral efficacy of entecavir (ETV)-based rescue therapy in lamivudine (LAM)-resistant chronic hepatitis B (CHB) patients. We retrospectively analyzed the efficacy of entecavir (ETV) monotherapy versus ETV-tenofovir disoproxil fumarate (TDF) combination therapy in 220 LAM-resistant CHB patients. Among 220 patients, 114 patients were treated with ETV monotherapy and 106 were treated with ETV-TDF combination therapy for at least 24 months. There were no significant differences between the two groups in baseline characteristics. During the follow-up of 24 months, virologic response (VR) occurred in 146 (66.4%) patients (58 patients belonged to the ETV monotherapy group and 88 patients belonged to the ETV-TDF combination group). The VR rates were different between the ETV and ETV-TDF groups (32.5% vs. 57.5% at 6 months, 50.0% vs. 77.4% at 12 months; and 50.9% vs. 83.0% at 24 months, P<0.001). In addition, both groups showed no difference in terms of the biochemical and HBeAg response. The rates of viral breakthrough at 6, 12 and 24 months were significantly different between ETV and ETV-TDF groups (2.63%, 4.39% and 9.65% vs. 0.00%, 0.94% and 1.89% at 6, 12 and 24 months, respectively). The ETV-TDF group was superior to the ETV group in achieving a virologic response. Moreover, the ETV-TDF was lower than the ETV group in achieving the initial viral breakthrough and genotypic mutations. Therefore, ETV-TDF combination therapy might be a better regimen than ETV monotherapy in the subgroup of LAM-resistant Chinese patients with CHB.

PMID:
    29609690
DOI:
    10.1691/ph.2018.7982

StephenW

Pharmazie。 2018年4月2日; 73（4）：223-247。 doi：10.1691 / ph.2018.7982。
基于恩替卡韦的挽救疗法在拉米夫定耐药慢性乙型肝炎患者中的疗效：回顾性研究。
李炜王，刘，李渝宇
抽象

有限的研究调查了拉米夫定（LAM）耐药慢性乙型肝炎（CHB）患者基于恩替卡韦（ETV）的救援疗法的抗病毒疗效。我们回顾性分析了恩替卡韦（ETV）单药治疗与ETV替诺福韦酯替诺福韦（TDF）联合治疗对220例LAM耐药CHB患者的疗效。在220例患者中，114例接受ETV单药治疗，106例接受ETV-TDF联合治疗至少24个月。基线特征两组之间没有显着差异。在随访24个月期间，146名患者（66.4％）发生了病毒学应答（VR）（58名患者属于ETV单药治疗组，88名属于ETV-TDF联合治疗组）。 ETV组和ETV-TDF组的VR率有所不同（6个月时为32.5％比57.5％，12个月时为50.0％比77.4％; 24个月时为50.9％vs. 83.0％，P <0.001）。此外，两组在生化和HBeAg应答方面没有差异。 ETV和ETV-TDF组在6,12和24个月时的病毒学突破率分别为6,12和24个月时分别为2.63％，4.39％和9.65％对0.00％，0.94％和1.89％ ）。 ETV-TDF组在获得病毒学应答方面优于ETV组。此外，ETV-TDF在实现最初的病毒突破和基因型突变方面低于ETV组。因此，ETV-TDF联合治疗可能是一个比ETV单药治疗更好的治疗方案，可用于抗CHAM的LAM耐药患者亚组。

结论：
    29609690
DOI：
    10.1691 / ph.2018.7982