貝西福韋治療可改善慢性乙型肝炎患者的肝臟組織學並減少

StephenW

貝西福韋治療可改善慢性乙型肝炎患者的肝臟組織學並減少共價閉合環狀 DNA
Hyung Joon Yim 1 , Won Kim 2 , Sang Hoon Ahn 3 , Young Kul Jung 1 , Soon Ho Um 1 , Joo Hyun Sohn 4 , Jae Young Jang 5 , Dong Joon Kim 6 , Eun-Sook Park 7 , So Young Jin 8 ,金均煥 9
隸屬關係
隸屬關係

    1
    高麗大學醫學院內科。
    2
    首爾國立大學醫學院內科，首爾市政府博拉梅醫療中心。
    3
    延世大學醫學院內科。
    4
    漢陽大學醫學院內科。
    5
    首爾順天鄉大學醫學院內科。
    6
    春川韓林大學醫學院內科。
    7
    建國大學醫學院癌症研究與診斷醫學中心藥理學系。
    8
    首爾順天鄉大學醫學院病理學系。
    9
    韓國水原成均館大學醫學院精準醫學系。

    PMID：34653281 DOI：10.1111/jgh.15710

抽象的

背景/目的：據報導，在慢性乙型肝炎 (CHB) 患者中，馬來酸貝西福韋酯 (BSV) 具有與富馬酸替諾福韋酯 (TDF) 相當的抗病毒功效和優越的腎臟和骨骼安全性。本研究旨在評估 BSV 治療與 TDF 治療相比肝臟組織學和肝內共價閉合環狀 DNA (cccDNA) 水平的變化。

方法：這是比較 BSV 與 TDF 的 3 期試驗的子集研究。其中，僅招募了願意參加組織學評估研究的 CHB 患者。進行了肝臟組織學檢查和肝內 cccDNA 定量。

結果：共有 46 名 CHB 患者接受了肝活檢（BSV，n = 29；TDF，n = 17）。治療 48 週後，組間病毒學應答率相當（P = 0.707）。隨訪肝活檢顯示，兩組的壞死性炎症均顯著改善。然而，BSV 組的組織學緩解率定義為改良組織學活動指數評分下降≥2 且未出現纖維化惡化的受試者比例高於 TDF 組（77.8% 對 36.4%，P = 0.048）。 Ishak 纖維化評分為 3 或更高的受試者比例在 BSV 中從 77.7% 降至 55.5%，在 TDF 組中從 72.7% 降至 45.4%。 BSV 或 TDF 治療 48 週後，肝內 cccDNA 較基線顯著降低（P <0.001），無組間差異（P = 0.349）。

結論：BSV 治療可改善 CHB 患者的肝臟組織學並減少肝內 cccDNA。

關鍵詞：貝西福韋；慢性乙型肝炎;纖維化；組織學；壞死性炎症。

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StephenW

Besifovir therapy improves hepatic histology and reduces covalently closed circular DNA in chronic hepatitis B patients
Hyung Joon Yim  1 , Won Kim  2 , Sang Hoon Ahn  3 , Young Kul Jung  1 , Soon Ho Um  1 , Joo Hyun Sohn  4 , Jae Young Jang  5 , Dong Joon Kim  6 , Eun-Sook Park  7 , So Young Jin  8 , Kyun-Hwan Kim  9
Affiliations
Affiliations

    1
    Department of Internal Medicine, Korea University College of Medicine.
    2
    Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center.
    3
    Department of Internal Medicine, Yonsei University College of Medicine.
    4
    Department of Internal Medicine, Hanyang University College of Medicine.
    5
    Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul.
    6
    Department of Internal Medicine, Hallym University College of Medicine, Chuncheon.
    7
    Department of Pharmacology, Center for Cancer Research and Diagnostic Medicine, Konkuk University School of Medicine.
    8
    Department of Pathology, Soonchunhyang University College of Medicine, Seoul.
    9
    Department of Precision Medicine, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea.

    PMID: 34653281 DOI: 10.1111/jgh.15710

Abstract

Background/aims: Besifovir dipivoxil maleate (BSV) was reported to have comparable antiviral efficacy and superior renal and bone safety to tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB) patients. The present study aims to evaluate changes of liver histology and intrahepatic covalently closed circular DNA (cccDNA) levels by BSV treatment in comparison with TDF therapy.

Methods: This is a subset study of the phase 3 trial comparing BSV with TDF. Among them, only CHB patients willing to participate in a histologic evaluation study were enrolled. Liver histologic examination and intrahepatic cccDNA quantification were performed.

Results: A total of 46 CHB patients received liver biopsies (BSV, n = 29; TDF, n = 17). After 48 weeks of treatment, virological response rate was comparable between the groups (P = 0.707). Follow-up liver biopsies showed that necroinflammation was significantly improved in the both groups. However, the histological response rate defined as the proportion of subjects whose modified histologic activity index score decreased by ≥2 without deterioration in fibrosis was higher in the BSV group than in the TDF group (77.8% versus 36.4%, P = 0.048). The proportion of subjects with Ishak fibrosis score 3 or more decreased from 77.7% to 55.5% in the BSV and that decreased from 72.7% to 45.4% in the TDF group. The intrahepatic cccDNA significantly decreased from baseline after 48 weeks of BSV or TDF treatment (P <0.001) without intergroup differences (P = 0.349).

Conclusions: BSV therapy improves hepatic histology and decreases intrahepatic cccDNA in CHB patients.

Keywords: Besifovir; Chronic hepatitis B; Fibrosis; Histology; Necroinflammation.

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小牡丹

贝西福韦就像是一只新牙膏，可以比替诺福韦刷牙效果更好。比taf怎么样？估计难分伯仲，或者略差一丢丢，不可说，不可说。也是鸡肋罢了，就像火车里吃的方便面，远远闻到气味好极了，吃的人感觉难以下咽，没有营养。