附加、改用 PEG-IFN 治疗策略可改善 CHB 患者的血清学反应

StephenW

附加、改用 PEG-IFN 治疗策略可改善 CHB 患者的血清学反应
6小时前
附加、改用 PEG-IFN 治疗策略可改善 CHB 患者的血清学反应

一项研究表明，长期使用恩替卡韦 (ETV) 治疗后出现病毒学应答的慢性乙型肝炎 (CHB) 患者，似乎在增加或改用聚乙二醇干扰素 (PEG-IFN) 治疗的策略中表现良好。

与连续 ETV 单药治疗相比，这两种方法都能改善乙型肝炎 e 抗原 (HBeAg) 血清转化和乙型肝炎表面抗原 (HBsAg) 降低。

这项多中心、平行、开放标签研究包括 153 名 HBeAg 阳性 CHB 患者，接受 ETV 治疗≥2 年，HBsAg <3,000 IU/ml，HBeAg <200 S/CO，HBV DNA <50 IU/ml。他们被随机分配接受 PEG-IFN 作为附加治疗 (n=50)，改用 PEG-IFN (n=52)，或继续 ETV 单药治疗 (n=51) 48 周。

在第 48 周发生 HBeAg 血清学转换的主要终点发生率在附加组和转换组中均显着高于连续 ETV 组（分别为 18.0% 和 19.2% 对 2.0%；p=0.007 和 p=0.005） ）。

对于 HBeAg 消失（分别为 24.0% 和 23.1% 对 5.9%；p=0.010 和 p=0.013），HBsAg <100 IU/ml（30.0% 和 34.6% 对 0%；p<0.001）观察到类似的结果模式第 48 周时 HBsAg 降低（-0.90 和 -0.92 vs -0.06 log10IU/ml；两者 p<0.001）。附加组和切换组之间的疗效没有显着差异（p>0.05） .

不良事件主要与 PEG-IFN 相关，但通常可以耐受。

Aliment Pharmacol Ther 2022;doi:10.1111/apt.17222

StephenW

Add-on, switch-to PEG-IFN therapy strategies improve serological response in CHB patients
6 hours ago
Add-on, switch-to PEG-IFN therapy strategies improve serological response in CHB patients

Chronic hepatitis B (CHB) patients, who have virological response with long-term entecavir (ETV) treatment, appear to fare well with a strategy of adding or switching to peginterferon (PEG-IFN) therapy, as shown in a study.

Both approaches result in improved hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) reduction relative to continuous ETV monotherapy.

The multicentre, parallel, open-label study included 153 HBeAg-positive CHB patients on ETV treatment ≥2 years, HBsAg <3,000 IU/ml, HBeAg <200 S/CO, and HBV DNA <50 IU/ml. They were randomized to receive PEG-IFN as an add on (n=50), switch to PEG-IFN (n=52), or continue ETV monotherapy (n=51) for 48 weeks.

The primary endpoint of HBeAg seroconversion at week 48 occurred with significantly greater frequency in both the add-on and switch-to groups than in the continuous ETV group (18.0 percent and 19.2 percent vs 2.0 percent; p=0.007 and p=0.005, respectively).

A similar pattern of results was observed for HBeAg loss (24.0 percent and 23.1 percent vs 5.9 percent; p=0.010 and p=0.013, respectively), HBsAg <100 IU/ml (30.0 percent and 34.6 percent vs 0 percent; p<0.001 for both), and HBsAg reduction (−0.90 and −0.92 vs −0.06 log10IU/ml; p<0.001 for both) at week 48. Efficacy did not significantly differ between the add-on and switch-to groups (p>0.05).

Adverse events were mainly related to PEG-IFN but generally tolerable.

Aliment Pharmacol Ther 2022;doi:10.1111/apt.17222