恩替卡韦和替诺福韦地索普西富马酸盐治疗初治和经验丰富

StephenW

Real-world single-center experience with entecavir and tenofovir disoproxil fumarate in treatment-naïve and experienced patients with chronic hepatitis B

Young Min Kim1, Hyun Phil Shin2, Joung Il Lee2, Kwang Ro Joo2, Jae Myung Cha2, Jung Won Jeon2, Jin Young Yoon2, Min Seob Kwak2
1 Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
2 Department of Gastroenterology and Hepatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea

Correspondence Address:
Dr. Hyun Phil Shin
Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul - 05278
Republic of Korea

Source of Support: None, Conflict of Interest: None
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DOI: 10.4103/sjg.SJG_49_18
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Background/Aim: The goal of antiviral therapy for chronic hepatitis B (CHB) is to improve survival of the patients by achieving a complete virological response (CVR). This study aimed to evaluate long-term efficacy of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) in nucleos(t)ide analog (NA)-naïve and NA-experienced Korean patients with CHB and to determine the incidence of cirrhosis-related complications in these patients. Patients and Methods: We retrospectively reviewed medical records of all patients treated with ETV or TDF from July 2007 to January 2017. We examined CVR and analyzed the predictive factors influencing the rate of CVR and evaluated the incidences of cirrhosis-related complications. Results: The proportion of patients who achieved CVR was 94.2% in the ETV group and 91.1% in the TDF group (P = 0.358). Among patients who achieved CVR, the mean time to CVR was 13.5 ± 14.3 months in the ETV group and 11.5 ± 10.6 months in the TDF group (P = 0.169). Positive predictive factors for CVR included the current treatment with TDF, a low hepatitis B virus DNA level, negative hepatitis B e-antigen status, and high alanine aminotransferase level in baseline laboratory test. The annual incidence rate of HCC was 127 per 10,000 patient-years (1.27% per year) in ETV group, and 85 per 10,000 patient-years (0.85% per year) in TDF group (P = 0.526). Conclusion: Both ETV and TDF therapy resulted in a high CVR, and the annual incidence rates of HCC and other cirrhosis-related complications were not significantly different between the two treatment groups.

StephenW

恩替卡韦和替诺福韦地索普西富马酸盐治疗初治和经验丰富的慢性乙型肝炎患者的真实世界单中心体验

年轻的Min Kim1，Hyun Phil Shin2，Joung Il Lee2，Kwang Ro Joo2，Jae Myung Cha2，Jung Won Jeon2，Jin Young Yoon2，Min Seob Kwak2
1韩国首尔庆熙大学研究生院医学系
2韩国首尔庆熙大学医学院江东庆熙大学医院消化内科和肝病科

通讯地址：
Hyun Phil Shin博士
首尔江东区东南路892号庆熙大学医学院江东庆熙大学医院内科 - 05278
大韩民国
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DOI：10.4103 / sjg.SJG_49_18
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背景/目的：慢性乙型肝炎（CHB）抗病毒治疗的目标是通过实现完整的病毒学应答（CVR）来提高患者的存活率。这项研究旨在评估恩替卡韦（ETV）和替诺福韦地索普西富马酸盐（TDF）在核苷（酸）类似物（NA）-naïve和NA经验的韩国CHB患者中的长期疗效，并确定肝硬化相关的发病率这些患者的并发症。患者和方法：我们回顾性分析了2007年7月至2017年1月所有接受ETV或TDF治疗的患者的医疗记录。我们检查了CVR并分析了影响CVR率的预测因素，并评估了肝硬化相关并发症的发生率。结果：获得CVR的患者比例在ETV组为94.2％，在TDF组为91.1％（P = 0.358）。在达到CVR的患者中，ETV组的平均CVR时间为13.5±14.3个月，TDF组为11.5±10.6个月（P = 0.169）。 CVR的阳性预测因子包括目前用TDF治疗，低乙型肝炎病毒DNA水平，乙型肝炎e抗原阳性状态和基线实验室检测中高丙氨酸氨基转移酶水平。在ETV组，HCC的年发病率为每10,000患者年127例（每年1.27％），TDF组为每10,000患者年85例（每年0.85％）（P = 0.526）。结论：ETV和TDF治疗均可导致高CVR，两组治疗后HCC和其他肝硬化相关并发症的年发病率无显着差异。

StephenW

http://www.saudijgastro.com/arti ... page=335;aulast=Kim

newchinabok

在ETV组，HCC的年发病率为每10,000患者年127例（每年1.27％），TDF组为每10,000患者年85例（每年0.85％）

newchinabok

十年一个周期看，恩替抗癌不如替诺，核衣壳快上市吧，期待强强联手抗癌

newchinabok

核衣壳上市的重要意义在于降hcc发病率

纠结哥哥

楼主 骆抗先统计替诺远远要优于这个数据啊

StephenW

回复 newchinabok 的帖子

ETV治疗组HCC年发病率为1.27％，TDF治疗组为0.85％，但差异无统计学意义.


[Table 5] shows the annual incidence rates of HCC and cirrhosis-related complications after antiviral therapy. A total of 13 of the 191 ETV-treated patients (6.8%) and 3 of the 112 TDF-treated patients (2.7%) developed HCC, and the annual incidence rates of HCC were 1.27% and 0.85% in ETV and TDF groups, respectively. However, the difference was not statistically significant (P = 0.526, [Figure 4]).
Next, the annual incidence rates of HCC were 1.27% in ETV treatment group and 0.85% in TDF treatment group, but the difference was not significant (P = 0.526). Recently published reports have shown that the annual incidence rates of HCC in ETV- or TDF-treated patients ranged from 0.01% to 5.4%.[31],[32],[33] Although these results are similar to those of our study, there are limitations not allowing an accurate evaluation of the incidence rate of HCC in our study because the number of patients was too small and the follow-up period was too short.
[表5]显示抗病毒治疗后HCC和肝硬化相关并发症的年发病率。 191例ETV治疗患者中共有13例（6.8％）和112例TDF治疗患者中有3例（2.7％）发生HCC，而ETV和TDF组的HCC年发病率分别为1.27％和0.85％， 分别。 然而，差异无统计学意义（P = 0.526，[图4]）。
其次，ETV治疗组HCC年发病率为1.27％，TDF治疗组为0.85％，但差异无统计学意义（P = 0.526）。 最近发表的报告显示，ETV或TDF治疗患者的HCC年发病率介于0.01％至5.4％之间[31]，[32]，[33]尽管这些结果与我们的研究相似， 在我们的研究中，由于患者数量太少而且随访时间太短，因此无法准确评估HCC的发病率。

StephenW

newchinabok 发表于 2018-11-19 21:15
核衣壳上市的重要意义在于降hcc发病率

为什么？

newchinabok

StephenW 发表于 2018-11-23 16:42
为什么？

因为核苷和核衣壳，事不同理同