恩替卡韦联合中药可降低慢乙肝患肝癌的风险

StephenW

恩替卡韦联合中药可降低慢乙肝患肝癌的风险
昨天
恩替卡韦联合中药可降低慢乙肝患肝癌的风险

最近的一项研究报告称，在慢性乙型肝炎 (CHB) 患者中，使用恩替卡韦 (ETV) 和抗纤维化中药鳖甲软肝复方 (BRC) 治疗有助于降低患肝细胞癌 (HCC) 的风险。

该研究包括 1,000 名患者（中位年龄 42.0 岁，男性占 69.9%），他们刚刚完成为期 72 周的 ETV+BRC 与 ETV+安慰剂比较研究，并进入开放标签治疗阶段。每 6 个月对患者进行一次随访，在此期间评估 HCC 的主要终点。

在改良的意向性治疗分析中，研究人员记录了接受 BRC 治疗的患者 7 年累计 HCC 发病率为 4.7%。相比之下，安慰剂组在同一时间跨度内的累积发生率为 9.3%。组间差异具有统计学意义 (p=0.008)。

肝脏相关死亡的次要结局也报告了类似的发现。 BRC 组和安慰剂组的 7 年累积发病率分别为 0.2% 和 2.2%，这对应于 BRC 的统计学显着优势 (p=0.03)。

值得注意的是，在 72 周时纤维化没有消退的患者中，ETV+BRC 组合对 HCC 的保护作用比单独使用 ETV 更弱 (p=0.018)。

多变量 Cox 回归分析表明，联合治疗显着降低了近 60% 的 HCC 风险（风险比，0.405，95% 置信区间，0.230–0.710；p=0.002）。

“虽然有有效的抗病毒治疗可以抑制慢性感染患者的病毒，但 HCC 的风险仍然存在。在此，我们表明，在抗病毒药物中加入一种名为鳖甲软肝的中药可以降低慢性乙型肝炎患者患肝癌的风险，”研究人员说。

J Hepatol 2022;77:1515-1524

StephenW

Entecavir plus traditional Chinese medicine cuts HCC risk in CHB
Yesterday
Entecavir plus traditional Chinese medicine cuts HCC risk in CHB

Among patients with chronic hepatitis B (CHB), treatment with entecavir (ETV) and Biejia-Ruangan compound (BRC), an antifibrotic traditional Chinese medicine, helps reduce the risk of hepatocellular carcinoma (HCC), a recent study reports.

The study included 1,000 patients (median age 42.0 years, 69.9 percent men) who had just completed a 72-week study comparing ETV+BRC against ETV+placebo and entered an open-label treatment phase. Patients were followed up every 6 months, during which the primary endpoint of HCC was assessed.

In the modified intention-to-treat analysis, the researchers recorded a 7-year cumulative incidence of HCC of 4.7 percent in the BRC-treated patients. In comparison, the placebo arm saw a cumulative incidence of 9.3 percent over the same time span. The difference between groups was statistically significant (p=0.008).

Similar findings were reported for the secondary outcome of liver-related deaths. The 7-year cumulative incidence rates were 0.2 percent and 2.2 percent in the BRC and placebo arms, respectively, which corresponded to a statistically significant advantage for BRC (p=0.03).

Of note, the ETV+BRC combo demonstrated a weaker protective effect than ETV alone against HCC in those whose fibroses did not regress by 72 weeks (p=0.018).

Multivariable Cox regression analysis showed that combination treatment significantly reduced HCC risk by nearly 60 percent (hazard ratio, 0.405, 95 percent confidence interval, 0.230–0.710; p=0.002).

“While there are effective antiviral treatments that can suppress the virus in chronically infected patients, the risk of HCC remains. Herein, we show that adding a traditional Chinese medicine called Biejia-Ruangan compound to an antiviral reduced the risk of HCC in patients with chronic hepatitis B,” the researchers said.

J Hepatol 2022;77:1515-1524