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韩国BMS:Baraclude组合疗法显示了治愈的希望 [复制链接]

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发表于 2018-6-21 10:53 |只看该作者 |倒序浏览 |打印
BMS Korea: Baraclude combo therapy shows promise for cure

    By Marian Chu
    Published 2018.06.20 17:16
    Updated 2018.06.20 17:16
  

A research team presented findings from a randomized controlled trial that evaluated the efficacy of a combination therapy comprising Baraclude (ingredient: entecavir), pegylated interferon alfa-2a, and a hepatitis B virus (HBV) vaccine.

The findings of the E+VIP study, which were presented at The Liver Week 2018 by Professors Kim Yoon-jun and Lee Jeong-hoon from Seoul National University College of Medicine, raised the possibility of a cure for the disease, Brisol-Myers Squibb said Wednesday.

"Since the functional cure of chronic hepatitis B has not been possible so far, the goal of treatment has been to prevent progression to severe liver disease and to improve survival by lowering the mortality rate,” Professor Kim said.

Currently, HBsAg-seroclearance is considered to be a functional cure for chronic hepatitis B patients although rarely achievable with oral nucleos(t)ide analogs (NAs) treatment alone.

“This E+VIP study administered Baraclude, pegylated interferon alfa-2a and then HBV vaccines to hepatitis B patients who achieved virological suppression after receiving Baraclude. Findings showed the rate of HBsAg-seroclearance, which can be regarded as a complete cure, was higher than any other studies and showed the possibility of a cure. This is very significant in the early stages of hepatitis B therapies,” Kim added.

The study aimed to evaluate the clinical efficacy of Baraclude, Peg-IFN and HBV vaccine as a combination therapy in 111 patients with chronic hepatitis B who were treated with Baraclude and had virological suppression.

Patients were randomly assigned to three groups: the treatment group, control group, and exploratory group. Study findings showed the probability of HBsAg-seroclearance was statistically higher in the combination therapy group that included Baraclude compared to the monotherapy group.

The treatment group (37 patients) taking Baraclude received weekly Peg-IFN injections for 48 weeks. Treatment was then followed by sequential administration of an HBV vaccine at 52, 56, 60, and 76 weeks. The control group (37 patients) received Baraclude as a monotherapy. The explorative group (37 patients) received Baraclude and Peg-IFN injection while simultaneously getting the HBV vaccine at 4, 8, 12, and 28 weeks.

There was no difference in baseline characteristics including qHBsAg, HBV DNA, HBeAg-positivity, and biochemical markers (e.g., ALT, AST, albumin) among three groups.

Intention-to-treat analysis showed chance of HBsAg-seroclearance at week 100 was statistically higher in the ETV + Peg-IFN + sequential vaccination treatment group at 16.2 percent than the comparison group with 0 percent. There was no statistically meaningful difference in the exploratory group of ETV + Peg-INF + simultaneous vaccination with 5.4 percent.

Changes in median qHBsAg titer from baseline to week 100 was –67.7% in the treatment group and –36.3% in the control group, respectively.

“The potential for cure of Baraclude and other vaccine combinations in this study is very promising for chronic hepatitis B patients and medical professionals,” BMS Korea CEO Park Hye-seon said.

[email protected]

<© Korea Biomedical Review, All rights reserved.>

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发表于 2018-6-21 10:53 |只看该作者
韩国BMS:Baraclude组合疗法显示了治愈的希望

    由Marian Chu
    发布时间2018.06.20 17:16
    更新2018.06.20 17:16
  

一个研究小组介绍了一项随机对照试验的结果,该试验评估了包含Baraclude(成分:恩替卡韦),聚乙二醇化干扰素α-2a和乙型肝炎病毒(HBV)疫苗的联合疗法的疗效。

E + VIP研究的结果在首尔国立大学医学院Kim Yoon-jun教授和Lee Jeong-hoon教授于2018年The Liver Week上发表,提出了治疗该疾病的可能性,Brisol-Myers Squibb周三表示。

“由于慢性乙型肝炎的功能性治愈迄今尚未实现,治疗的目标是预防进展至严重肝病并通过降低死亡率来提高存活率,”Kim教授说。

目前,HBsAg血清学清除被认为是治疗慢性乙型肝炎患者的功能性治疗方法,但单独使用口服核苷(t)类似物(NAs)治疗很难达到。

“这项E + VIP研究将Baraclude,聚乙二醇干扰素α-2a和乙肝疫苗接种给接受Baraclude后实现病毒学抑制的乙型肝炎患者。调查结果显示,HBsAg血清学清除率可视为一种完全治愈,高于其他研究,并显示治愈的可能性。这在乙肝治疗的早期阶段非常重要,“Kim补充说。

该研究旨在评估Baraclude,Peg-IFN和HBV疫苗作为联合疗法治疗111例接受Baraclude治疗且病毒学抑制的慢性乙型肝炎患者的临床疗效。

患者被随机分为三组:治疗组,对照组和探索组。研究结果显示,与单药治疗组相比,包括Baraclude在内的联合治疗组的HBsAg血清清除率的概率更高。

服用Baraclude的治疗组(37名患者)每周接受Peg-IFN注射48周。随后在52,56,60和76周依次接种HBV疫苗。对照组(37名患者)接受Baraclude作为单一疗法。探索组(37名患者)接受Baraclude和Peg-IFN注射,同时在4,8,12和28周时接受HBV疫苗。

基线特征包括qHBsAg,HBV DNA,HBeAg阳性和生化标志物(如ALT,AST,白蛋白)在三组间没有差异。

意向治疗分析显示,ETV + Peg-IFN +序贯接种治疗组在100周时HBsAg血清学清除的机会比对照组为0.2%的患者高出16.2%。在ETV + Peg-INF +同时接种疫苗的探索组中,5.4%没有统计学意义上的差异。

从基线到第100周,qHBsAg滴度中位数的变化分别为治疗组-67.7%和对照组-36.3%。

BMS韩国首席执行官Park Hye-seon说:“本研究中Baraclude和其他疫苗组合的治疗潜力对于慢性乙型肝炎患者和医疗专业人员来说是非常有前景的。

[email protected]

<©韩国生物医学评论,保留所有权利>

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发表于 2018-6-21 18:13 |只看该作者
联合用药是有希望的,单打独斗必败。

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发表于 2018-7-1 05:19 |只看该作者
本帖最后由 pourvivre 于 2018-6-30 16:21 编辑

很不错的治疗方向。 也许ETV换成TAF会提高一点点成绩。  但是全文我没发现是否区分HbeAg 阴性和阳性。
Replicor 公司也做了针对小三阳患者的实验, 三药贯序,TDF peg-IFN 和 REP2139 或 REP20165 效果也不错,不过没有亚洲实验者,在东欧做的。
Preliminary safety and efficacy of REP 2139-Mg or
REP 2165-Mg used in combination with tenofovir
disoproxil fumarate and pegylated interferon alpha 2a
in treatment naïve Caucasian patients with chronic
HBeAg negative HBV infection
(REP 401 protocol)
有兴趣可以看报告  http://replicor.com/wp-content/uploads/2016/11/Replicor-REP-401-AASLD-2016-LB-7.pdf
小三男感染36年

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发表于 2018-7-1 08:51 |只看该作者

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发表于 2018-7-1 08:56 |只看该作者
pourvivre 发表于 2018-7-1 05:19
很不错的治疗方向。 也许ETV换成TAF会提高一点点成绩。  但是全文我没发现是否区分HbeAg 阴性和阳性。
Repl ...

rep2139,到底中不中咧?俺说“不中”
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