entecavir v.s lamivudine

yuer

在B型肝炎治療上Entecavir比Lamivudine更安全有效


Entecavir能治癒79％以上Lamivudine無法治療的病毒血症


　　到目前為止，Lamivudine是唯一取得國家認證的治療慢性B型肝炎（HBV）的口服藥物。但是研究結果發現：Entecavir對Lamivudine治療失敗的患者也有效。11月9日－13日，在Texas Dallas舉行的美國肝臟疾病研究學會上，研究者報導了以下研究結果：Entecavir是一種鳥嘌吟核甘酸同功異構體，對於Lamivudine治療失敗的HBV患者，它能有效治療其病毒血症。
　　據報導，接受Lamivudine治療的HBV患者，近20％的人服藥1年後會產生抗藥性，隨著服用該藥時間的延長，產生抗藥性的患者也日益增多。因此Entecavir有可能拯救這部分患者。

　　該研究的作者，邁阿密大學的Eugene Schiff說到：「研究結果證明這種口服藥效果極好， Lamivudine治療失敗的患者，大部分都會產生抗藥性，但口服Entecavir則較為有效」。

　　研究試驗組受試者包括181名HBV患者，試驗組隨機分為三組，每天分別口服0.1毫克、0.5毫克或1毫克Entecavir，總共服藥52週。在第24週時，每天口服0.1毫克的受試者中19％的病人含有不可測的B型肝炎病毒DNA，0.5毫克組中53％患者、1毫克組中79％的患者，和繼續口服Lamivudine的患者組中13％的人，含有不可測的B型肝炎病毒DNA。

　　患者一般容易接受Entecavir治療，181名患者中，僅有9人因為副作用而拒絕繼續治療。研究開始前，受試者各組基礎ALT和治療期間ALT正常的比例分別是：口服0.1毫克Entecavir組為37％，口服0.5毫克Entecavir 組為60％，口服1毫克Entecavir組為36％，繼續口服Lamivudine的患者組為21％。

　　Schiff說到：「每天口服1毫克Entecavir的患者組（79％含有不可測性DNA）轉氨酵素正常的百分數較低，這可能與轉氨酵素升高人數的百分數較高有關，轉氨酵素升高時間比HBV DNA增高出現較早。」其值升高通常表示治療有效。

　　其他9名因副作用停藥的患者停止用藥後，其他所有生化改變恢復正常。所有其他副作用為輕度或中度，Entecavir和Lamivudine組副作用的發生頻率相似。

　　Schiff說到「應當進一步研究，以證明Entecavir是一種很好的治療B型肝炎的輔助藥物，對於Lamivudine治療失敗的患者來說，這是一種安全又有效的新藥」。




Entecavir Safe, More Effective Than Lamivudine For Hepatitis B

Reverses Viremia in Up To 79% Of Patients Failing Lamivudine


By Laurie Barclay, MD
WebMD Medical News


Reviewed by Dominique Walton Brooks, MD, MBA


Nov. 20, 2001 -- Entecavir is effective even in patients who fail therapy with lamivudine, the only currently approved oral antiviral drug for chronic hepatitis B (HBV). At the American Association for the Study of Liver Diseases meeting in Dallas, Texas, from November 9-13, researchers presented efficacy data for entecavir, a guanosine nucleoside analogue, in HBV patients who were viremic on lamivudine.


As nearly 20% of patients treated with lamivudine become refractory within one year of therapy, and more become resistant with continued therapy, entecavir may come to the rescue for these patients.


"This oral agent has proven to be highly effective," said author Eugene Schiff of the University of Miami. "Most of the patients who failed lamivudine therapy developed escape variants, which were effectively treated by entecavir."


Researchers treated 181 patients with 0.1mg, 0.5mg, or 1mg entecavir daily for 52 weeks. At 24 weeks, 19% of patients treated with 0.1mg had undetectable HBV DNA, as did 53% of patients on 0.5mg, 79% on 1mg, and 13% of patients who continued treatment with lamivudine.


Entecavir was generally well tolerated, with only nine of 181 patients discontinuing the treatment because of adverse events. The percentage of patients with abnormal ALT at the start of the study and normalized ALT during treatment with entecavir was 37% with 0.1mg, 60% with 0.5mg, and 36% with 1mg, compared to 21% who continued treatment with lamivudine.


"The lower percentage who normalized aminotransferase in the group who received 1 mg (79% DNA undetectable) may be related to a higher percentage of flares in aminotransferase prior to disappearance of HBV DNA," Schiff said. "Flares often mean that the patient is responding to the treatment."


All biochemical changes in those nine patients resolved uneventfully when entecavir was discontinued. All other adverse events were of mild to moderate severity and occurred with similar frequency in the groups taking entecavir and lamivudine.


"Entecavir therapy should prove to be a welcome addition to the management of patients with hepatitis B," Schiff said. "It is a safe and effective new drug for patients with hepatitis B who failed lamivudine therapy."

冰狐

i hope so, but i don't want to  believe it because pseudoscience is available even in american.

yuer

以下是引用冰狐在2002-11-22 13:27:00的发言：
i爃ope爏o,燽ut爄燿on't爓ant爐o牋believe爄t燽ecause爌seudoscience爄s燼vailable爀ven爄n燼merican.

人生有梦，筑梦踏实！伪科学到处都有，但我记得看过这样一部小说揳 room with a view", 窗外有蓝天，如果连心窗都关上了，还有什么意思呢？

良子

Live!