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发表于 2004-5-2 00:45
Combination Therapy with Peginterferon Alfa-2b (PEG-IFN) and Lamivudine Is More Effective Than PEG-IFN Alone, But Does Not Result in Greater Sustained Response Rates
To evaluate viral dynamics during therapy with pegylated interferon alfa-2b/ PEG-IFN (PEG-Intron) and to establish if combination therapy with lamivudine (Epivir-HBV) has an additive effect, researchers in Rotterdam, The Netherlands? analyzed viral decline in 36 HBeAg positive chronic hepatitis B patients who completed 24 weeks of PEG-IFN monotherapy or combination therapy.
Serum HBV-DNA levels were measured frequently (days 0-4, 7, 14, 21, 28, and monthly thereafter) to assess HBV dynamics. Response (serum HBeAg loss) was achieved in 7 (39%) of the combination therapy group and 8 (44%) of the monotherapy group.
Results
Throughout the study period, the investigators found a significantly faster HBV-DNA decline in the combination therapy group, compared to the monotherapy group.
In the combination therapy group they found a biphasic decline of HBV-DNA. The efficacy of combination therapy was 94.9%. In this group HBV-DNA decline during the first week was associated with response.
In the monotherapy group a more complex HBV-DNA decay pattern was found, not fitting a biphasic model. In this group a typical staircase pattern with minimal decline in the first weeks but a sudden HBV-DNA decrease after 12 to 20 weeks was found in 6 of the 8 responders (75%).
Conclusions
The authors conclude, 揅ombination therapy with PEG-IFN and lamivudine is more effective in suppressing HBV replication than PEG-IFN [monotherapy]. This did not result in enhanced sustained response rates.?/span>
揙nly for patients treated with combination therapy, initial decline of HBV-DNA was indicative of response.?For patients treated with PEG-IFN alone response was associated with HBV-DNA decline after 12 weeks, probably due to enhanced immune reactivity.?/font>
04/30/04
Reference
M van Zonneveld and others. VIRAL DYNAMICS DURING PEG-INTERFERON ALONE AND IN COMBINATION WITH LAMIVUDINE. Abstract 446. 39th EASL. April 14-18, 2004. Berlin, Germany.
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